Pemberton's sign was named after

Hugh Pemberton Hugh Pemberton may refer to: * Hugh Pemberton (physician), English physician *Hugh Pemberton (historian) * Hugh Pemberton (MP) for City of London (Parliament of England constituency) The City of London was a parliamentary constituency of the ...

, who characterized it in 1946. The Pemberton maneuver is a physical examination tool used to demonstrate the presence of latent pressure in the thoracic inlet. The maneuver is achieved by having the patient elevate both arms (usually 180 degrees anterior flexion at the shoulder) until the forearms touch the sides of the face. A positive Pemberton's sign is marked by the presence of facial congestion and cyanosis, as well as respiratory distress after approximately one minute.

Causes

A positive Pemberton's sign is indicative of

superior vena cava syndrome Superior vena cava syndrome (SVCS), is a group of symptoms caused by obstruction of the superior vena cava ("SVC"), a short, wide vessel carrying circulating blood into the heart. The majority of cases are caused by malignant tumors within the m ...

(SVC), commonly the result of a mass in the

mediastinum The mediastinum (from ) is the central compartment of the thoracic cavity. Surrounded by loose connective tissue, it is an undelineated region that contains a group of structures within the thorax, namely the heart and its vessels, the esophagu ...

. Although the sign is most commonly described in patients with substernal goiters where the goiter “corks off” the thoracic inlet, the maneuver is potentially useful in any patient with adenopathy, tumor, or fibrosis involving the mediastinum. SVC syndrome has been observed as a result of diffuse mediastinal lymphadenopathy of various pathologies such as cystic fibrosis and Castleman’s disease. Park ''et al.'' reported enlarged cervical lymph nodes associated with hemophagocytic lymphohistiocytosis as the cause of internal jugular vein compression, which presented clinically similar to SVC syndrome.

Causes

References

Further reading