scholarly journals Vertebral Artery Stenting in a Patient With Bow Hunter’s Syndrome

2019 ◽  
Vol 1 (1) ◽  
pp. 73-74
Author(s):  
Niya Boykova Mileva ◽  
Dobrin Iotkov Vassilev ◽  
Ivanichka Serbezova ◽  
Gianluca Rigatelli ◽  
Robert J. Gill
Keyword(s):  
Vertebral Artery ◽  
Hunter's Syndrome ◽  
Vertebral Artery Stenting

Vertebral Artery Stenting for the Treatment of Bow Hunter’s Syndrome: Report of 4 Cases

2012 ◽  
Vol 21 (8) ◽  
pp. 908.e1-908.e5 ◽  
Author(s):  
M. Ziad Darkhabani ◽  
Matthew C. Thompson ◽  
Marc A. Lazzaro ◽  
Muhammad A. Taqi ◽  
Osama O. Zaidat
Keyword(s):  
Vertebral Artery ◽  
Hunter's Syndrome ◽  
Vertebral Artery Stenting ◽  
Syndrome Report

Atlanto-Occipital Decompression of Vertebral Artery for a Variant of Bow Hunter's Syndrome: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Nickalus R Khan ◽  
Turki Elarjani ◽  
Stephanie H Chen ◽  
Laszlo Miskolczi ◽  
Sheryl Strasser ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Rare Condition ◽  
Head Rotation ◽  
Treatment Modalities ◽  
Spinal Instability ◽  
Vertebrobasilar Insufficiency ◽  
Common Etiology ◽  
Neurologically Intact ◽  
Hunter's Syndrome ◽  
Visual Abnormalities

Abstract Rotational vertebral artery (VA) occlusion syndrome, also known as bow hunter's syndrome, is an uncommon variant of vertebrobasilar insufficiency typically occurring with head rotation.1-3 The most common presenting symptom is dizziness (76.8%), followed by visual abnormalities and syncope (50.4% and 40.4%, respectively).2 Osteophytic compression due to spinal spondylosis has been shown to be the most common etiology (46.2%), with other factors, such as a fibrous band, muscular compression, or spinal instability, being documented.1,2 Treatment is dependent on the level and site of VA compression with anterior, anterolateral, or posterior approaches being described.1,4 We present the case of a 72-yr-old male with osteophytic compression of the V3 segment of the vertebral artery at the occipital-cervical junction. The patient underwent a C1 hemilaminectomy and removal of osteophytic compression from the occipital-cervical joint. The patient had complete resolution of compression of his vertebral artery on postoperative imaging and remained neurologically intact following the procedure. We review the literature on this topic, the technical nuances of the procedure performed, and review the different treatment modalities available for this rare condition.1-11  The patient consented to the procedure and to publication of their image.

scholarly journals Comparison of drug-eluting and bare metal stents for extracranial vertebral artery stenting

2019 ◽  
Vol 15 (3) ◽  
pp. 328-337
Author(s):  
Damian Maciejewski ◽  
Piotr Pieniazek ◽  
Lukasz Tekieli ◽  
Piotr Paluszek ◽  
Tadeusz Przewlocki ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Bare Metal Stents ◽  
Metal Stents ◽  
Bare Metal ◽  
Drug Eluting ◽  
Extracranial Vertebral Artery ◽  
Vertebral Artery Stenting

scholarly journals Rotational vertebrobasilar insufficiency due to compression of a persistent first intersegmental vertebral artery variant: case report

2017 ◽  
Vol 26 (2) ◽  
pp. 199-202 ◽  
Author(s):  
Vivek P. Buch ◽  
Peter J. Madsen ◽  
Kerry A. Vaughan ◽  
Paul F. Koch ◽  
David K. Kung ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Dynamic Compression ◽  
Posterior Circulation ◽  
Posterior Arch ◽  
Vertebrobasilar Insufficiency ◽  
Digital Subtraction ◽  
Head Turning ◽  
Atlantoaxial Fusion ◽  
Episodic Vertigo ◽  
Hunter's Syndrome

Rotational vertebrobasilar insufficiency, or bow hunter's syndrome, is a rare cause of posterior circulation ischemia, which, following rotation of the head, results in episodic vertigo, dizziness, nystagmus, or syncope. While typically caused by dynamic occlusion of the vertebral artery in its V2 and V3 segments, the authors here describe a patient with dynamic occlusion of the vertebral artery secondary to a persistent first intersegmental artery, a rare variant course of the vertebral artery. In this case the vertebral artery coursed under rather than over the posterior arch of the C-1. This patient was also found to have incomplete development of the posterior arch of C-1, as is often seen with this variant. The patient underwent dynamic digital subtraction angiography, which demonstrated occlusion at the variant vertebral artery with head turning. He was then taken for decompression of the vertebral artery through removal of the incomplete arch of C-1 that was causing the dynamic compression. After surgery the patient had a complete resolution of symptoms. In this report, the authors present the details of this case, describe the anatomical variants involved, and provide a discussion regarding the need for atlantoaxial fusion in these patients.

Bow Hunter’s Syndrome in Children: A Review of the Literature and Presentation of a New Case in a 12-Year-Old Girl

2020 ◽  
Vol 35 (11) ◽  
pp. 767-772 ◽  
Author(s):  
Meredith R. Golomb ◽  
Katrina A. Ducis ◽  
Mesha L. Martinez
Keyword(s):  
Vertebral Artery ◽  
English Language ◽  
Recurrent Stroke ◽  
Head Rotation ◽  
Hunter Syndrome ◽  
Artery Occlusion ◽  
Vascular Compression ◽  
Cervical Fusion ◽  
Male Predominance ◽  
Hunter's Syndrome

Background: Bow hunter's syndrome, or occlusion of the vertebral artery with head rotation leading to ischemia and sometimes stroke, is rarely described in children. The authors review the literature and present a new case. Methods: Both OVID dating back to 1946 and PubMed records were reviewed using the terms (“Bow hunter syndrome” OR “bow hunter’s”) OR “rotational vertebral artery occlusion” combined with “child,” and limited to English language. SCOPUS and the bibliographies of cases found in the search were used to identify additional articles. Results: Twelve articles were found describing 25 patients; there were 26 patients when combined with our case. Ages ranged from 1 to 18 years. Most (88.5%, 23/26) were male. Medical treatments included aspirin, clopidogrel, abciximab, enoxaparin, warfarin, and cervical collar. Stenting was tried in 2 cases but did not work long-term. Surgical treatments included decompression, cervical fusion, or a combination. We present a new case of a 12-year-old girl with recurrent stroke who had bilateral vascular compression only visible on provocative angiographic imaging with head turn. She was referred for cervical fusion, and abnormal ligamentous laxity was noted intraoperatively. Conclusions: Bow hunter's syndrome is a rare but important cause of stroke since many of the patients experience recurrent strokes before the diagnosis is made. Reasons for the male predominance are unclear. Provocative angiography plays a key role in diagnosis, and both medical treatment and neurosurgical intervention may prevent recurrence.

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