History: A 65-year-old, right hand dominant woman presents with intermittent presyncopal episodes, usually experienced during the day while working around the house. She also c/o of progressive right hand and forearm paresthesias. She has a 90 pack-year smoking history and approximately 10 year history of mild hypertension for which she does not take medication.
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Teaching Point or Hint: Arch injection - early image
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