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Bow Hunter stroke

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).

Safain MG, Talan J, Malek AM, Hwang SW. Spontaneous atraumatic vertebral artery occlusion due to physiological cervical extension. J Neurosurg Spine. 2014 Jan 17. [Epub ahead of print] PubMed PMID: 24438424.
Iida Y, Murata H, Johkura K, Higashida T, Tanaka T, Tateishi K. Bow hunter's syndrome by non-dominant vertebral artery compression; A case report, literature review and significance of downbeat nystagmus as the diagnostic clue. World Neurosurg. 2018 Jan 5. pii: S1878-8750(18)30022-6. doi: 10.1016/j.wneu.2017.12.167. [Epub ahead of print] PubMed PMID: 29309982.
Cornelius JF, George B, N'dri Oka D, Spiriev T, Steiger HJ, Hänggi D. Bow-hunter's syndrome caused by dynamic vertebral artery stenosis at the cranio-cervical junction–a management algorithm based on a systematic review and a clinical series. Neurosurg Rev. 2012 Jan;35(1):127-35; discussion 135. doi: 10.1007/s10143-011-0343-4. Epub 2011 Jul 26. PubMed PMID: 21789571.
bow_hunter_stroke.txt · Last modified: 2018/01/10 09:50 by administrador