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Panminerva Medica 2002 March;44(1):47-59

lingua: Inglese

New concept regarding chest pain due to hypoxia of the internal mammary arteries in more than 1,600 operated patients with cerebral thoracic neurovascular syndrome (CTNVS)

Fernandez Noda E. I., Rivera Luna H., Perez Fernandez J., Castillo J., Perez Izquierdo M., Estrada C.

From the Bayamon Family Hospital, Bayamon, Puerto Rico


In ­this ­article we ­describe the ­role of com­pres­sion of the ver­te­bral, sub­cla­vian, ­internal mam­mary, ­internal ­carotid ­arteries, bra­chial ­plexus and ­coiling and ­kinking of the ver­te­bral and bas­ilar ­arteries, the ­faulty irri­ga­tion of ­blood ­supply and ­oxygen of the cer­e­bellum and ­basal gan­glia and ­other ­areas of the ­brain fol­lowed by meta­bolic pro­cesses. Among the ­effects are: a ­decrease in the secre­tion of dop­a­mine at the ­level of the ­putamen, ­which pro­duces the symp­toms of symptomatic Parkinson’s dis­ease, ­chorea due to ­chronic tran­si­tory ­faulty ­blood ­supply and ­oxygen to the cau­date ­nucleus, bal­lism by ­hypoxia at the ­level of sub-thalamic and thalamus ­nuclei and athet­osis in the len­tic­ular ­nucleus. This com­pres­sion is ­caused by hyper­trophy of the ante­rior scal­enus mus­cles and the cer­vical ­ribs at the ­level of the verte­brae C6-C7; by the ster­no­clei­do­mas­toid at the ­level of the cer­vical ­atlas, by the pectoralis minor mus­cles and ­coiling and ­kinking of the ver­te­bral, bas­ilar and the ­internal ­carotid ­arteries. The ­decreased ­blood ­supply to the cer­e­bellum and ­basal gan­glia is the ­cause of the cerebral thoracic neuro vascular syndrome (­CTNVS) and its neu­ro­log­ical com­pli­ca­tions, ­among ­which are ipsi­lat­eral par­al­ysis, symptomatic Parkinson’s dis­ease, functional Alzheimer’s dis­ease multiple sclerosis and ­others. We are pres­ently ­engaged in ­genetic ­studies to ­widen our under­standing of ­these ill­ness.

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