Vertebral artery occlusion is a serious and potentially life-threatening occurrence. Bow hunter's syndrome, a mechanical occlusion of the VA due to physiological head rotation, has been well described in the medical literature. However, mechanical VA compression due to routine flexion or extension of the neck has not been previously reported 1).
Bow hunter's syndrome (BHS)
Iida et al. report a case of BHS induced by non-dominant VA compression, in which contralateral VA patency was preserved. Definite diagnosis of BHS is not often feasible due to transient symptoms and non-specific clinical features such as vertigo or dizziness, especially in non-dominant VA compression 2).
Today, there are still no standard treatment options for BHS because of its rarity. Multiple management strategies have been presented in the literature including conservative, surgical and, more recently, endovascular intervention 3).