Autonomic Dysregulation Attributed to Vertebral Artery Insufficiency Secondary to Subclavian Steal Syndrome: A Case Report

Anatomic malformation as seen in subclavian steal syndrome leads to an alteration in the body's autonomic regulatory pattern, influencing varying physical manifestations. The autonomic nervous system provides situational regulatory feedback to the body, maintaining the body’s desired point of homeostasis. We report the case of a 68-year-old male who initially came in with X-rays indicating retrolisthesis and calcifications in his carotids. A left-sided carotid bruit was also noted, as well as right-sided upper extremity weakness. Continued imaging studies indicated structural changes to his cervical regions and continued calcifications in the remainder of his arterial supply branching off of his carotid arteries. The patient's denial of surgical intervention led to treatments focused on symptomatic control until more conclusive data could be collected and interpreted.