Aneurysm of Circumflex Humeral Arteries in a Volleyball Player

Introduction and radial arteries. There was a temperature difference between arm and forearm and the hand was cool and pale. He also reported that he had experienced a Arterial injuries of the shoulder in ‘‘throwing’’ athletes sudden numbness in his right hand of a few hours’ are not yet very common and usually are the result duration twice, in the previous month. The patient’s of subclavian artery damage due to the thoracic outlet past medical history was unremarkable. After a sucsyndrome. However, arterial damage can also occur cessful transbranchial embolectomy the circulation of distal to the thoracic outlet in the second and third the upper extremity has been restored and pulse was part of the axillary artery and its branches, especially detected in the ulnar, radial and brachial arteries. the anterior and posterior humeral arteries. Thorough postoperative clinical examination did ‘‘Hyperabduction syndrome’’, a condition in which not reveal any pathological findings. X-ray and MRI the second part of the axillary artery becomes occluded examination were negative for thoracic outlet synby extrinsic pressure from the overlying pectoralis drome. Heart ultrasonographic examination was also minor, was first described by Wright in 1945. normal. Laboratory tests for hypercoagulative disThrombosis of the third part of the axillary artery orders were negative. Colour duplex of the right arm has been reported as a result of repetitive trauma of showed a possible aneurysmal dilatation of circumflex the artery from the humeral head at the point beyond humeral arteries. Finally, angiography of the aortic the pectoralis minor and exactly anterior to the huarch and both arms was performed with the use of meral head. Also, trauma at this point is responsible Seldinger technique. The aortic arch, the proximal for axillary and very rarely for posterior or anterior brachiocephalic vessels and the arteries of the left arm circumflex humeral artery aneurysm formation with showed no abnormalities. In the right arm a 2 cm long or without digital embolisation. The ‘‘quantrilateral aneurysm formation was disclosed at the common space syndrome’’ has also been reported in this area origin of circumflex humeral arteries. Since the results caused by compression of the posterior circumflex of all the additional examinations were normal, the humeral artery in the quantrilateral space, with pain aneurysm of the circumflex arteries was considered to and paresthesia of the upper extremity. be responsible for the arm embolisation. Subsequent embolisation, with the use of coils (Cook’s stainless steel Occluding Spring Embolus) successfully elimCase Report inated the aneurysm. During an 8-month follow-up period the patient A 21-year-old volleyball player was admitted to our had no complaints and he had already started playing department with signs of acute ischaemia of the right volleyball without any problems. arm. On physical examination pulse was present in the axillary artery, but absent in the brachial, ulnar Discussion