{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T04:19:32Z","timestamp":1776917972673,"version":"3.51.2"},"reference-count":19,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,10,17]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2023-255694","type":"journal-article","created":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T12:05:30Z","timestamp":1699963530000},"page":"e255694","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Brachial artery aneurysm and bilateral posterior circulation strokes in a young child with tuberous sclerosis complex"],"prefix":"10.1136","volume":"16","author":[{"given":"Juliette A","family":"Meyer","sequence":"first","affiliation":[{"name":"Department of Paediatrics, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand"},{"name":"Paediatric Neuroservices, Starship Children's Health, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Graydon","sequence":"additional","affiliation":[{"name":"Paediatric Orthopaedic Department, Starship Children's Health, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl","family":"Muthukumaraswamy","sequence":"additional","affiliation":[{"name":"Vascular and Transplant Service, Auckland City Hospital, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3449-9298","authenticated-orcid":false,"given":"Hannah F","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand"},{"name":"Paediatric Neuroservices, Starship Children's Health, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,11,14]]},"reference":[{"key":"2025082708135022000_16.11.e255694.1","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.114.001493","article-title":"Cardiovascular manifestations of tuberous sclerosis complex and summary of the revised diagnostic criteria and surveillance and management recommendations from the international tuberous sclerosis consensus group","volume":"3","author":"Hinton","year":"2014","journal-title":"J Am Heart Assoc"},{"key":"2025082708135022000_16.11.e255694.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-010-1689-5"},{"key":"2025082708135022000_16.11.e255694.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2021.07.011"},{"key":"2025082708135022000_16.11.e255694.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61279-9"},{"key":"2025082708135022000_16.11.e255694.5","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1002\/ajmg.c.31648","article-title":"Less common manifestations in TSC","volume":"178","author":"Boronat","year":"2018","journal-title":"Am J Med Genet C Semin Med Genet"},{"key":"2025082708135022000_16.11.e255694.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-008-0813-1"},{"key":"2025082708135022000_16.11.e255694.7","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1111\/dmcn.14313","article-title":"Cerebellar lesions as potential predictors of neurobehavioural phenotype in tuberous sclerosis complex","volume":"61","author":"Toldo","year":"2019","journal-title":"Dev Med Child Neurol"},{"key":"2025082708135022000_16.11.e255694.8","doi-asserted-by":"publisher","DOI":"10.1007\/BF00341764"},{"key":"2025082708135022000_16.11.e255694.9","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.pediatrneurol.2012.10.011","article-title":"A magnetic resonance imaging study of cerebellar volume in tuberous sclerosis complex","volume":"48","author":"Weisenfeld","year":"2013","journal-title":"Pediatr Neurol"},{"key":"2025082708135022000_16.11.e255694.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2012.09.060"},{"key":"2025082708135022000_16.11.e255694.11","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-010-1466-5"},{"key":"2025082708135022000_16.11.e255694.12","doi-asserted-by":"crossref","unstructured":"Libby PA , Maitem AN , Strauss EB . Axillary artery aneurysm in a patient with Tuberous sclerosis. 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