Session Information
Session Title: AA 2021 Virtual Posters - General Rehabilitation
Session Time: None. Available on demand.
Disclosures: Andrew C. Wondra, MD:
Case Diagnosis: A Unique Presentation of an Acute Stroke Following a Rare Left Subclavian Anomaly with a Kommerell Diverticulum: Case Report
Case Description: A 55-year-old female presented with bronchitis incidentally found to have a right-sided aorta on chest X-ray, with further imaging demonstrating an aberrant left subclavian artery originating from a Kommerell diverticulum on CT angiogram. Given the size of the aortic diameter and Kommerell diverticulum in addition to her presentation with orthopnea, surgery was advised. She underwent an ascending aortic arch debranching with grafting, post-operatively presented new neurologic deficits including left-sided hemiplegia. MRI revealed a large perfusion deficit within the ICA territory as the result of an acute right CCA thrombus requiring urgent thrombectomy. The patient presented to acute rehabilitation with significant neurological deficits including impaired strength, balance, and endurance limiting her ability to transfer, ambulate and perform activities of daily living.
Setting: Acute Rehabilitation HospitalAssessment/
Results: After intensive inpatient rehabilitation focusing on preventative education, mobility, balance, and gait training, the patient was able to ambulate without the use of aids and perform all daily activities with supervision to complete independence at the time of discharge.
Discussion: This case is especially unique given the low prevalence of the population with aberrant left subclavian arteries and more rarely associated with a Kommerell diverticulum. As a postoperative complication to aortic repair, only eight percent of these patients suffer an acute stroke. Rehabilitation outcomes for this condition are not well studied.
Conclusion: Acute stroke in the setting of a rare vascular anomaly presents unique rehabilitation challenges requiring acute rehabilitation.
Level of Evidence: Level V
To cite this abstract in AMA style:
Wondra AC, Simlote S, Thalla N. A Unique Presentation of an Acute Stroke Following a Rare Left Subclavian Anomaly with a Kommerell Diverticulum: Case Report [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/a-unique-presentation-of-an-acute-stroke-following-a-rare-left-subclavian-anomaly-with-a-kommerell-diverticulum-case-report/. Accessed May 25, 2025.« Back to AAPM&R Annual Assembly 2021
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/a-unique-presentation-of-an-acute-stroke-following-a-rare-left-subclavian-anomaly-with-a-kommerell-diverticulum-case-report/