Thromboembolism of the subclavian artery to the vertebral artery with haemorrhagic transformation — a case report

We report on the case of a 56-year-old male patient who, after fainting, regained consciousness in hospital in a confused state complaining of pain in the left arm. In the physical examination, the arm was seen to be cold and without pulse, so an arteriography was performed which identified an aneurysm of the subclavian artery with distal embolus of the upper limb. He was submitted to embolectomy of the limb but evolved with degeneration of the neurological state and so was transferred to a university hospital which confirmed the presence of thromboembolism of the vertebral artery. The upper limb had signs of distal ischaemia, so anticoagulation with heparin was initiated. The patient presented with further deterioration of the neurological condition and a transformation from ischaemic to hemorrhagic stroke was confirmed.