The subclavian steal syndrome is caused by a combination of the shunting of blood from a highto a low-pressure system and reduction of flow through the vertebral-basilar arteries. There are several collateral channels that may develop to circumvent proximal subclavian occlusion, the pathway chosen being the one that offers least resistance. Other hemodynamic abnormalities besides a stenosed proximal subclavian artery are probably present in the intracranial or extracranial vessels that supply the cerebral circulation. A search for correctable lesions other than subclavian stenosis should be carried out. Otolaryngologists should maintain a high index of suspicion for the syndrome when confronted with a patient with vertigo.
Trevino RJ. Thyrocervical Steal Syndrome. Arch Otolaryngol. 1970;92(2):177–180. doi:10.1001/archotol.1970.04310020075019
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