Headache as the Leading Symptom of the Thoracic Outlet Syndrome

SYNOPSIS Intractable headache is a common presenting symptom of the thoracic outlet syndrome (TOS). We followed thirty patients for at least six months after transaxillary first rib resection. Prior to surgery, twenty‐six reported recurring headache before the appearance of neck and shoulder pain; headache was lateralized in 21 and continual in 14. In 11, intensification of TOS symptoms accompanied headache. After surgery, 11 previously disabled patients returned to work; 13 became head‐ache‐free. Eleven others reported benefit from vaso‐active drugs that had been ineffective pre‐operatively.