Cerebral blood flow and metabolism of steal syndrome evaluated by PET

Subclavian steal syndrome is precipitated by arm exercise.1 There have been no reports of PET findings during steal syndrome, however, because arm exercise rarely provokes cerebral symptoms.2 We present here a case of subclavian steal syndrome caused by aortitis syndrome due to Takayasu’s arteritis, in which global cerebral hypoperfusion was detected during arm exercise with PET. A 38-year-old woman was admitted to our hospital because of frequent syncope attacks, often induced by neck extension and exercise of her arms. She was diagnosed with Takayasu’s arteritis based on systemic angiographic findings (aorta, major arteries, cerebral arteries, pulmonary arteries); clinical symptoms; physiologic findings (e.g., pulseless radial artery, significant difference of blood pressure in four extremities, heart murmur); and laboratory data.3 Angiography revealed severe stenosis in the bilateral common carotid and right vertebral arteries, mild stenosis in the left vertebral artery, and complete obstruction of the left axillary artery. Intracranial …