title: Venous Thoracic Outlet Syndrome as a Cause of Intractable Migraines.
abstract: Thoracic outlet syndrome (TOS) refers to the compression of the neurovascular bundle within the thoracic outlet. Cases are classified by primary etiology-arterial, neurogenic, or venous. In addition to the typical symptoms of arm swelling and paresthesias, headaches have been reported as a potential symptom of TOS. In this report, we describe a patient with debilitating migraines, which were consistently preceded by unilateral arm swelling. Resolution of symptoms occurred only after thoracic outlet decompression. Patients with migraines and concomitant swelling and/or paresthesias, especially related to provocative arm maneuvers, should be considered a possible atypical presentation of TOS and evaluated in more detail.
authors.affiliation: Division of Vascular and Endovascular Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Veer
authors.initials: V
authors.lastname: Chahwala
authors.affiliation: Division of Vascular and Endovascular Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Jun
authors.initials: J
authors.lastname: Tashiro
authors.affiliation: Division of Vascular and Endovascular Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL. Electronic address: x.li10@med.miami.edu.
authors.forename: Xiaoyi
authors.initials: X
authors.lastname: Li
authors.affiliation: Division of Vascular and Endovascular Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Atif
authors.initials: A
authors.lastname: Baqai
authors.affiliation: Division of Vascular and Endovascular Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Jorge
authors.initials: J
authors.lastname: Rey
authors.affiliation: Division of Vascular and Endovascular Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Handel R
authors.initials: HR
authors.lastname: Robinson
mesh_terms: D000328:Adult; D002560:Cerebrovascular Circulation; D019299:Decompression, Surgical / Q000379:methods; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D010690:Phlebography; D012039:Regional Blood Flow; D013901:Thoracic Outlet Syndrome / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*