![]() ![]() It may also be the most underrated, overlooked, misdiagnosed, and probably the most important and difficult to manage peripheral nerve compression in the upper extremity. This article is concerned with thoracic outlet compression syndrome (TOCS), one of the most controversial subjects in medicine. Below are some interesting quotes related to thoracic outlet syndrome. This can cause a truly weird and confusing constellation of symptoms.ĭespite more than 2600 references to TOS on pubmed, there is still wide controversy regarding TOS no concrete diagnostic criteria have been established, and many practitioners claim that the whole problem is a fad which does not really exist. It has also been shown that TOS may cause secondary dysautonomic symptoms both due to its influence on craniovascular blood supply but also due to its potential for concomitant affection of the sympathetic nerves that connect to the brachial plexus. 2020) and cause craniovascular hyperperfusion. In cases where the vertebral artery is not rotationally compromised, compression of the subclavian artery will still influence craniovascular hemodynamics, because reduction of flow to the arm will increase flow rates to the head via the carotid and vertebral arteries, as shown in our recent study (Larsen et al. The VA supplies the brain with blood, and is therefore especially important to assess for symptoms of vertebrobasilar insufficiency. ![]() A branch of the subclavian artery include a key vessel, the vertebral artery. The reason why the potential symptoms are all over the spectrum, is because it in addition to compression of the entire brachial plexus nerve network which innervates the arms as well as parts of the chest, neck and back, also may compress the subclavian artery & vein. It has potential to cause numerous types and areas of pain, such as neuralgia in the arms, chest, between the shoulder blades and in the back (figure 1), dizziness, brain fog, migraine, headaches, a feeling of being “heavy-headed”, etc. TOS is considered to be one of modern medicine’s most difficult issues, because of the complex and variable nature of its symptoms. ![]()
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