Abstract
We report here the case of a 57-year-old man with subclavian steal syndrome who demonstrated transient ischemic attack of the right middle cerebral artery. The patient had a history of transient dysarthria and right hemiplegia. The blood pressure in his left arm was 126/72 mmHg, whereas that in his right arm was very low (70/52 mmHg) and pulsation of the right radial artery was undetectable. Angiography revealed 90% stenosis of the brachiocephalic artery and reversed flow of the right vertebral artery. Also, 70% stenosis of the left internal carotid artery was observed, and collateral circulation to the posterior part of the left middle cerebral artery was noted from the left posterior cerebral artery. After undergoing angioplasty using a balloon-expanded stent, the patient showed no ischemic attack. In this case, the transient ischemic attack of the left middle cerebral artery territory was probably the result of concurrence of subclavian steal phenomenon from the severe stenosis of the brachiocephalic artery and left carotid artery stenosis.
