Abstract
The thoracic outlet syndrome involves neurovascular compression at the site where the brachial plexus and subclavian vessels pass through the isthmus of the root of the neck. This disorder, which may be overlooked by neurosurgeons, is diagnosed mainly on the basis of subjective symptoms and objective findings. Such objective manifestations as supraclavicular tenderness and radial pulse obliteration may be elicited by the Morley and Allen tests, respectively. Positional angiography offers the most precise means of localizing the compression. The aim of surgery is to create an adequate passage for the neurovascular bundle. The authors prefer the supraclavicular approach to thoracic outlet decompression and emphasize complete decompression, i.e., scalenotomy and resection of the first rib. The importance of this disorder and its surgical management are discussed.
