A 40-year-old female with no co morbidities presented to our emergency department with a complaint of severe Left upper limb pain associated with weakness, numbness and tingling sensation in fingers for past two days. H/O patient had syncope, facial weakness, dysarthria at afternoon lasted for less than 10 mins on the presenting day of hospital. Past history of patient use to develop bluish swelling below the clavicle after sternous activity and it disappear after rest. On examination: Patient ABCDE intact CNS examination showed - decrease in power (4/5) in left upper limb, weak hand grasp. Tinels sign positive.
Adson test negative. Provocative elevation positive. Another systemic examination was with in normal limit. So we initially did a CT head which was normal and Cervical spine x-ray showed a Cervical rib. According to the complaints, history and clinical findings, we came to the…
