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Mandeep Garewal, MD; John B. Selhorst, MD

Arch Neurol. 2005;62:1917-1919.

Background  Subclavian artery dissection is a rare entity. It is usually associated with anomalous aortic vasculature. Only with trauma or catheterization procedures is subclavian artery dissection with normal aortic vasculature reported.

Patient  We describe a patient with intrascapular pain, an occipital headache, and 3 distinct infarctions in the nervous system. He had spontaneous subclavian artery dissection with normal aortic vasculature.

Conclusion  Subclavian artery dissections should be suspected in patients with intrascapular pain, occipital or cervical pain, and symptoms within the posterior circulation.

Author Affiliations: Department of Neurology, Souers Stroke Institute, Saint Louis University, St Louis, Mo.