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Brachial artery aneurysm and bilateral posterior circulation strokes in a young child with tuberous sclerosis complex
  1. Juliette A Meyer1,2,
  2. Andrew Graydon3,
  3. Carl Muthukumaraswamy4 and
  4. Hannah F Jones1,2
  1. 1Department of Paediatrics, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
  2. 2Paediatric Neuroservices, Starship Children's Health, Auckland, New Zealand
  3. 3Paediatric Orthopaedic Department, Starship Children's Health, Auckland, New Zealand
  4. 4Vascular and Transplant Service, Auckland City Hospital, Auckland, New Zealand
  1. Correspondence to Dr Hannah F Jones; hannahj{at}


Although tuberous sclerosis (TS) may affect many organs, vascular manifestations involving medium- and large-size vessels are rare. We present a young child with known TS who presented with bilateral posterior circulation infarcts and subsequently was found to have right-hand ischaemia secondary to a thrombosed brachial artery aneurysm. A wound on his right middle finger failed to heal with conservative management, and digital subtraction angiography and MR angiogram demonstrated a lack of bypass target with microcollateral supply of the forearm only. The right middle digit ischaemia was initially managed with right middle finger disarticulation at the metacarpophalangeal joint, but the wound failed to heal and the patient proceeded to a thumb-sparing carpo-metacarpal amputation. Aneurysms, stenotic-occlusive disease and embolic stroke are rare but important complications of TS.

  • Neuro genetics
  • Neuroimaging
  • Stroke
  • Orthopaedics
  • Vascular surgery

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  • Contributors JAM wrote the manuscript. AG, CM and HFJ reviewed and contributed to the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.