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Brain and Nerve No to Shinkei Volume 17, Issue 6 （June 1965）

Brain and Nerve 脳と神経 17巻6号（1965年6月発行）

Japanese English

研究

Hyperabduction Syndrome （Neurovascular Compression Syndrome）の診断と治療 DIAGNOSIS AND TREATMENT FOR HYPER ABDUCTION SYNDROME OF THE UPPER EXTREMITY 石井昌三 ¹ , 山本豊城 ¹ , 三谷哲美 ¹ Shozo ISHII ¹ , Toyoshiro YAMAMOTO ¹ , Tetsumi MITANI ¹ ¹大阪赤十字病院脳神経外科 ¹Neurosurgical Dept. of Osaka Redcross. Hosp. pp.603-608

発行日 1965年6月1日 Published Date 1965/6/1

DOI https://doi.org/10.11477/mf.1406201863

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Abstract 文献概要
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I．緒言

　われわれは，最近，一側の上肢に，疼痛，異常感覚，冷感，しびれ感などのいわゆる神経脈管圧迫症候群（neurovascular compression syndrome）^1）と理解すべき症状を呈し，しかも従来よく知られている前斜角筋症候群あるいは頸肋症候群とはまつたくその成因を異にする1症例を経験したのでここに報告し，あわせて，その診断法，治療法についても若干の考察を加えてみた。

A case of hyperabduction syndrome was reported.

A 39-year-old telegraph operator had complained of slowness in writing, easy fatigability and paresthesia of right hand and fingers for one year. The patient had been studied in another hospital and conservative therapy was applied, including extension of neck without improvement of symptoms.

On Oct. 12, 1963, he was admitted to the neurosur-gical department of Osaka Red-cross Hospital.

Neurological examination was essentially normal. The hands were warm and no trophic changes were present. The radial pulse was palpable bilaterally. There was tenderness in the right supraclavicular groove. Plain X-ray of cervical spine and E. M. G. of upper extremities revealed no abnormalitiy. The venous pressure in the posture of hyperabduction of right upper extremity was approximately 80 mmH₂0 higher and blood pressure in hyperabduction was 47 mmHg lower than those in neutral position. Diagnostic maneuver of hyperabduction syndrome was positive, dampening the right radial pulse, whereas Adson's maneuver showed no effect on the pulse. On the left side, these tests were negative. Transcubital venography and trensbrachial retrograde arteriography revealed constriction both in subclavian vein and artery at their cross point with subclavius muscle and costo-coracoid ligament in hyperabduction of right upper extremity.

On Nov. 25, an operation was performed, consisting of total resection of the subclavius muscle and costo-co-racoid ligament with section of the scalenus anticus muscle.

By 17 postoperative day, venous pressure and blood pressure in right arm returned to normal and he was discharged on Jan. 15, 1964, being asymptomatic.

A discussion was made on etiology, diagnosis and treatment of this condition.