Stroke associated with subclavian robbery syndrome: clinical case report

Abstract

Objective: To report a unique case of a patient with cerebrovascular accident (CVA) associated with subclavian steal syndrome, thus increasing early diagnostic clinical suspicion, limiting complications and decreasing exacerbations. Case details: A 58-year-old male patient with a history of labyrinth disease was admitted to a hospital in the interior of São Paulo after to have headache, hoarseness, rotational vertigo, cyanosis in the left upper limb and change in mean arterial pressure in the upper limbs, being considered hypothesis of stroke associated with subclavian steal syndrome. Imaging exams showed areas of acute and subacute injuries with a hemorrhagic component and loss of flow-void in segments of the left vertebral artery. The patient underwent clinical-surgical treatment, with return of pulses in the upper limb, remained cyanosis in the fifth finger of the left hand and ataxia of the left upper limb, occasional vertigo and progressive decrease in hoarseness, being referred for follow-up. Final considerations: Because it is a relatively rare disease, recognizing signs and symptoms of vertebrobasilar insufficiency and a detailed clinical history is necessary for an early diagnosis, seeking to limit complications and reduce episodes of exacerbation over the years, in addition to favoring a better strategy of treatment for each patient.