scholarly journals A thromboembolic mechanism in bow hunter's stroke: Importance of hemodynamic evaluation by ultrasonography during head rotation

2020 ◽  
Vol 20 ◽  
pp. 100254
Author(s):  
Nobuyuki Eura ◽  
Kozue Saito ◽  
Hironori Shimizu ◽  
Yasuhiro Takeshima ◽  
Midori Shima ◽  
...  
Keyword(s):  
Head Rotation ◽  
Hemodynamic Evaluation ◽  
Bow Hunter’S Stroke

Comparison of C1–2 posterior fusion and decompression of the vertebral artery in the treatment of bow hunter's stroke

1997 ◽  
Vol 86 (4) ◽  
pp. 619-623 ◽  
Author(s):  
Takeshi Matsuyama ◽  
Tetsuya Morimoto ◽  
Toshisuke Sakaki
Keyword(s):  
Vertebral Artery ◽  
Head Rotation ◽  
Posterior Fusion ◽  
Vertebrobasilar Insufficiency ◽  
Content Type ◽  
Long Term Follow Up ◽  
Life Threatening ◽  
Neck Rotation ◽  
Bow Hunter’S Stroke

✓ Bow hunter's stroke results from vertebrobasilar insufficiency caused by mechanical occlusion or stenosis of the vertebral artery (VA) at the C1–2 level on head rotation. Surgical treatment of this condition may be chosen to avoid life-threatening accidents or because patients complain that conservative treatments such as verbal warnings or use of a neck brace to limit head and neck rotation are ineffective and thus restrict their lifestyle. Posterior fusion involving C1–2 has long been used to limit atlantoaxial rotational movements. However, it has the serious disadvantage that the range of head motion is severely reduced. Recently, decompression of the atlantoaxial portions of the affected VA has been used because it does not limit physiological neck movements. However, no long-term follow-up review of patients who have undergone this procedure has been conducted, and it is unclear whether this procedure always provides relief of symptoms. To answer this question, the results of C1–2 posterior fusion were compared with decompression of the VA for the treatment of bow hunter's stroke.

Angiographic Examination and Surgical Treatment of Bow Hunter's Stroke

Neurosurgery ◽  
1988 ◽  
Vol 23 (2) ◽  
pp. 228-232 ◽  
Author(s):  
Junya Hanakita ◽  
Hidenori Miyake ◽  
Shinji Nagayasu ◽  
Shyogo Nishi ◽  
Takanori Suzuki
Keyword(s):  
Surgical Treatment ◽  
Vertebral Artery ◽  
Dura Mater ◽  
Surgical Procedure ◽  
Cervical Vertebrae ◽  
Head Rotation ◽  
Head Motion ◽  
Vertebral Arteries ◽  
Angiographic Examination ◽  
Bow Hunter’S Stroke

ABSTRACT Anatomically, the vertebral artery courses through six foramina transversaria of the cervical vertebrae, passing through the groove on the surface of the arch of the atlas and then penetrating the dura mater. Because of this anatomical course, the vertebral arteries are often affected by head motion. Stenotic change of the vertebral artery can occur at the atlantoaxial level in head rotation. Such a special type of stroke was named “bow hunter's stroke” by Sorensen. We report three cases of bow hunter's stroke and discuss the angiographic examinations. As surgical treatment, we performed partial transversectomy of the atlas vertebra, with favorable results. The usefulness of this surgical procedure is discussed.

scholarly journals Juvenile Bow Hunter's Stroke without Hemodynamic Changes

2010 ◽  
Vol 3 ◽  
pp. CCRep.S3555 ◽  
Author(s):  
Kozue Saito ◽  
Makito Hirano ◽  
Toshiaki Taoka ◽  
Hiroyuki Nakagawa ◽  
Takanori Kitauchi ◽  
...  
Keyword(s):  
Cerebrovascular Disease ◽  
Vertebral Artery ◽  
Male Patient ◽  
Head Rotation ◽  
Underlying Mechanism ◽  
Vertebrobasilar Insufficiency ◽  
Hemodynamic Changes ◽  
Artery Embolism ◽  
Vertebrobasilar Stroke ◽  
Bow Hunter’S Stroke

Bow hunter's stroke (BHS) is a cerebrovascular disease caused by occlusion of the vertebral artery (VA) on head rotation. BHS is generally associated with hemodynamic changes, often leading to vertebrobasilar insufficiency symptoms, such as vertigo and faintness. Although artery-to-artery embolism has also been proposed as an underlying mechanism, it remains controversial. This report documents a case of BHS without hemodynamic changes. We describe a 26-year-old male patient who had VA occlusion on head rotation and repetitive infarction of thalami. He had an anomalous bypass of the VA and therefore no symptomatic hemodynamic changes. Thus, non-hemodynamic BHS should be considered in juvenile patients with vertebrobasilar stroke.

Anterolateral decompression of the atlantoaxial vertebral artery for symptomatic positional occlusion of the vertebral artery

1995 ◽  
Vol 83 (4) ◽  
pp. 737-740 ◽  
Author(s):  
Mark W. Fox ◽  
David G. Piepgras ◽  
John D. Bartleson
Keyword(s):  
Vertebral Artery ◽  
Head Rotation ◽  
Artery Occlusion ◽  
Left Vertebral Artery ◽  
Vertebrobasilar Insufficiency ◽  
Mechanical Compression ◽  
Head Turning ◽  
Content Type ◽  
The Right ◽  
Bow Hunter’S Stroke

✓ A case of repeated vertebrobasilar ischemic attacks related to head rotation (bow hunter's stroke) is reported. With head rotation of 45° or more to the right, the patient would become lightheaded and feel as if she were going to lose consciousness. Angiography performed when head rotation was to the right revealed mechanical compression of the left vertebral artery at the foramen transversarium of the axis and an occluded right vertebral artery. Untethering of the vertebral artery as it passed through the foramen transversarium of the atlas in this case completely relieved the patient's symptoms. The authors conclude that contralateral vertebral artery occlusion predisposed this patient to symptomatic vertebrobasilar insufficiency secondary to ipsilateral vertebral artery mechanical stenosis induced by head turning.

Clinical Case Studies in Renal Transplantation

2013 ◽  
Vol 12 (2) ◽  
pp. 75-75
Keyword(s):  
Risk Assessment ◽  
Chronic Kidney Disease ◽  
Pulmonary Hypertension ◽  
Renal Transplantation ◽  
Kidney Disease ◽  
Case Studies ◽  
Clinical Case ◽  
Hemodynamic Evaluation ◽  
Clinical Case Studies

The case studies below are referred to in the articles “Pulmonary Hypertension in Patients with Chronic Kidney Disease: Noninvasive Strategies for Patient Phenotyping and Risk Assessment” by Amresh Raina, MD, and “Hemodynamic Evaluation of Pulmonary Hypertension in Chronic Kidney Disease” by Ryan Tedford, MD, and Paul Forfia, MD, on the following pages.

Facial expression differences indicate pain improvement at the emergency department

2020 ◽  
Keyword(s):  
Emergency Department ◽  
Aspect Ratio ◽  
Facial Expressions ◽  
Pain Measurement ◽  
Rating Scale ◽  
Head Rotation ◽  
Numeric Rating Scale ◽  
Nasolabial Fold ◽  
Measurement Strategy ◽  
Pain Improvement

Purpose: Pain is a major symptom for patients to seek medical services, but limited evidence supports the applicability and usage of facial expressions as a pain measurement strategy in the emergency department (ED). In this study, we explored possible differences in facial expressions before and after pain management and compared these differences with those in a self-reported pain scale. Methods: In this observational study, convenience sampling of patients admitted to the ED was conducted. Two video sessions of facial expressions were recorded for each participant, and participants rated their painon a self-reported numeric rating scale (NRS). A total of 25 facial parameters were extracted per frame. The main outcome measurements were the differences in facial parameters, and their correlation with changes in NRS scores was examined. Results: This study included 163 participants. A stronger reduction in NRS scores was associated with differences in systolic blood pressure (sBPr = 0.247, P = 0.011) and the following changes in facial features: eye opening (left: r = -0.210, P = 0.007; right: r = -0.206, P = 0.008), eye aspect ratio (left: r = -0.382, P < 0.001; right: r = -0.305, P < 0.001), and head rotation angle (r = 0.218, P = 0.005). Pain improvement (a difference of ≥ 4 in NRS scores) was associated with differences in BP (sBP, odds ratio [OR] = 0.973, 95%confidence interval [CI]: 0.949-0.998, P = 0.034; dBP, OR = 1.078, 95% CI: 1.026-1.113, P = 0.003), eye aspect ratio (Left: β = 5.613, 95% CI: 2.234-14.104, P < 0.001; Right: β = 2.743, 95% CI: 1.395-5.391, P = 0.003), and nasolabial fold variation (β = 0.548, 95% CI: 0.306-0.982, P = 0.043), after adjustment for variables Conclusions: Intraindividual changes in facial expressions can be used to track clinically relevant differences in pain. Facial expressions alone cannot be used as a pain measurement strategy in the ED.

scholarly journals Does Head Orientation Influence 3D Facial Imaging? A Study on Accuracy and Precision of Stereophotogrammetric Acquisition

2021 ◽  
Vol 18 (8) ◽  
pp. 4276
Author(s):  
Giuditta Battistoni ◽  
Diana Cassi ◽  
Marisabel Magnifico ◽  
Giuseppe Pedrazzi ◽  
Marco Di Blasio ◽  
...  
Keyword(s):  
Head Rotation ◽  
Anthropometric Measurements ◽  
Head Orientation ◽  
3D Images ◽  
Face Shape ◽  
Operator Error ◽  
Accuracy And Precision ◽  
Error Magnitude ◽  
Repeatability And Reproducibility ◽  
Head Positions

This study investigates the reliability and precision of anthropometric measurements collected from 3D images and acquired under different conditions of head rotation. Various sources of error were examined, and the equivalence between craniofacial data generated from alternative head positions was assessed. 3D captures of a mannequin head were obtained with a stereophotogrammetric system (Face Shape 3D MaxiLine). Image acquisition was performed with no rotations and with various pitch, roll, and yaw angulations. On 3D images, 14 linear distances were measured. Various indices were used to quantify error magnitude, among them the acquisition error, the mean and the maximum intra- and inter-operator measurement error, repeatability and reproducibility error, the standard deviation, and the standard error of errors. Two one-sided tests (TOST) were performed to assess the equivalence between measurements recorded in different head angulations. The maximum intra-operator error was very low (0.336 mm), closely followed by the acquisition error (0.496 mm). The maximum inter-operator error was 0.532 mm, and the highest degree of error was found in reproducibility (0.890 mm). Anthropometric measurements from alternative acquisition conditions resulted in significantly equivalent TOST, with the exception of Zygion (l)–Tragion (l) and Cheek (l)–Tragion (l) distances measured with pitch angulation compared to no rotation position. Face Shape 3D Maxiline has sufficient accuracy for orthodontic and surgical use. Precision was not altered by head orientation, making the acquisition simpler and not constrained to a critical precision as in 2D photographs.

Sign in / Sign up

Export Citation Format

Share Document