Distal subclavian artery occlusion causing multiple cerebral infarcts consequence of retrograde flow of a thrombus?

[thoracic outlet syndrome]

Intracranial embolization usually arises from the heart , a vertebrobasilar artery , a carotid artery , or the aorta , but rarely from the distal subclavian artery upstream of an embolus . We report on a patient who experienced left shoulder and forearm pain with weak blood pressure and pulse followed by concurrent onset of left hemiplegia . This case is a rare example of multiple cerebral embolic infarctions , which developed as a complication of distal subclavian artery thrombosis possibly associated with protein S deficiency .