FIG 1. CT angiogram of the chest at admission.

A, The left brachiocephalic vein (arrow) is compressed by a brachiocephalic artery dissection (not shown) and associated mediastinal hematoma (black arrowheads). An endotracheal tube, enteric tube, right thoracostomy tube (white arrowheads), right pneumothorax, and pneumomediastinum (asterisks) are present.

B, Note dilation of the accessory hemiazygos vein (white arrowhead) and enlarged vein within the neural foramen (black arrowhead).

C, Maximum-intensity-projection image of the CT angiogram demonstrates constriction of the brachiocephalic vein (arrowhead) and dilation of the accessory hemiazygos vein (large arrow) and epidural venous plexus (small arrows).