Neck ischemic throbbing pain
Introduction
Introduction Ischemic thoracic neck is a clinical manifestation of anterior scalene syndrome. The anterior scalene muscle is located in the deep part of the lateral side of the cervical vertebrae and starts from the anterior nodules of the cervical vertebrae 3-6 transversely, ending at the inner rib cage of the first rib. Anterior scalene muscle syndrome refers to anterior scalene muscle edema caused by various causes, hyperplasia, sputum and lifting of the first rib, leading to stenosis of the scalene muscle, compression of the brachial plexus and subclavian arteries and veins The corresponding clinical symptoms of the disease.
Cause
Cause
The disease is related to the triangular space formed by the oblique muscles of the neurovascular bundle.
1, congenital malformation: the anterior middle scalene muscles become a piece, so the brachial plexus must be opened before the middle scalene muscle fibers pass through.
2, anterior scale muscle hypertrophy: can be primary, or secondary anterior scalene tendon caused by stimulation of the brachial plexus.
3. The attachment point of the anterior scalene muscle causes the narrowing of the triangular gap.
Examine
an examination
Related inspection
Carotid artery color Doppler neck test
Diagnosis is based on clinical manifestations.
The anterior scalene symptom group occurs in middle-aged people, more women than men, and the right side is more than the left side. The patient generally has muscles that are sagging shoulders and shoulder straps, and the symptoms are different due to the compressed tissue.
1. Subclavian artery compression
The pain is ischemic jumping pain, the onset can be sudden, accompanied by soreness and discomfort, starting from the neck to the hands and fingers, with numbness and tingling, the pain site has no clear boundaries, cervical activity It can aggravate the pain. When the neck is straight, the scalene muscle space becomes smaller and the pain is aggravated. The neck flexion can increase the space between the scalene muscles, and the pain can be relieved. Pulling the affected limb to lower the shoulder blades can aggravate the symptoms.
2. Brachial plexus compression
This condition occurs in long-term lesions, underlying dryness of the brachial plexus, which is acute pain and radiates from the inside of the forearm and 4,5 fingers.
3. The subclavian artery and brachial plexus are simultaneously compressed
This condition is the same as the symptoms of the neck rib. The patient usually supports the head with his hand to tilt it to the affected side, thereby relieving the tension of the anterior scalene muscle. The supraclavicular fossa can be paralyzed and the anterior scalene muscle is tense, tender, and oppressed. Muscles cause severe tenderness and radiation pain. The neck stretches and aggravates pain. Sometimes allergies and coldness appear in the hands, and movement disorders and reflexes disappear.
The auxiliary examination methods for this disease mainly include X-ray examination and angiography and CT examination:
1, X-ray film can be used to exclude the deformity of the cervical and thoracic vertebrae - such as the neck rib or the first rib abnormalities.
2, angiography is valuable for the diagnosis of this disease, this method can also be used to locate the compression of the subclavian artery.
3, CT examination: CT can be seen due to muscle cell hypertrophy caused by increased cross-sectional area; muscle fiber hyperplasia can lead to local density increase, CT value increases when adhesion to surrounding tissue makes CT film showing the front bevel muscle and surrounding tissue unclear .
Diagnosis
Differential diagnosis
Differential diagnosis of ischemic neck pain in the neck:
1. Neck pain: The neck muscle ligament is the source of our soreness. The posture is not correct and the muscle ligament strength is not enough for a long time. Therefore, we must change the posture from time to time. When it is pressed to the nerve, it is easy to cause discomfort and the posture is incorrect. It is more likely to cause bone spurs, and our muscle tissue can not withstand long-term pressure and grinding.
2, cervical vertebrae pain: cervical vertebra pain is one of the clinical symptoms of cervical spondylosis, cervical spondylosis, also known as cervical vertebra syndrome, is the general term for cervical osteoarthritis, proliferative cervical spondylitis, cervical nerve root syndrome, cervical disc herniation, is a A condition based on degenerative pathological changes.
3, neck pain: neck pain problems, whether in young people, or middle-aged and older people, is a common problem. Its symptoms are local and conductive. The so-called locality refers to pain in the neck alone, which may be a ligament sprain, a muscle strain, or a joint wear degradation. The so-called conductivity refers to the situation of the hand numbness and hand soreness in addition to the neck discomfort. This is mostly because the cervical nerve root is compressed, or the fascia from the neck to the arm and even the wrist, inflammation, adhesion, The situation of austerity.
