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Bow hunter’s syndrome successfully treated with a posterior surgical decompression approach:A case report and review of literature

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World Journal of Clinical Cases 2022年第14期10卷 4494-4501页

作者： NiccolòOrlandi Francesco Cavallieri Ilaria Grisendi Antonio Romano Reza Ghadirpour Manuela Napoli Claudio Moratti Matteo Zanichelli rosario pascarella Franco Valzania Marialuisa Zedde Department of Biomedical Metabolic and Neural SciencesCenter for Neuroscience and NeurotechnologyUniversity of Modena and Reggio EmiliaModena 41121Italy Neurology Unit Neuromotor and Rehabilitation DepartmentAzienda USL-IRCCS di Reggio EmiliaReggio Emilia 42123Italy Clinical and Experimental Medicine PhD Program University of Modena and Reggio EmiliaModena 41121Italy Neurosurgery Unit Neuromotor and Rehabilitation DepartmentAzienda USL-IRCCS di Reggio EmiliaReggio Emilia 42123Italy Neuroradiology Unit Department of Diagnostic Imaging and Laboratory MedicineAzienda USL-IRCCS di Reggio EmiliaReggio Emilia 41123Italy

BACKGROUND Bow hunter’s syndrome(BHS)is a rare but surgically treatable cause of vertebrobasilar insufficiency due to dynamic rotational occlusion of the vertebral ***,patients present with posterior circulation transient ischaemic symptoms such as presyncope,syncope,vertigo,diplopia,and horizontal nystagmus,but irreversible deficits,including medullary and cerebellar infarctions,have also been *** SUMMARY A 70-year-old patient presented an acute onset of vertigo and gait instability triggered by right head *** medical history included previous episodes of unilateral left neck and occipital pain followed by light-headedness,sweating,and blurred vision when turning his head,and these episodes were associated with severe degenerative changes in the atlanto-dens and left atlanto-axial facet joints and right rotation of the C2 cervical *** magnetic resonance imaging revealed the presence of acute bilateral cerebellar ischaemic lesions,while static vascular imaging did not reveal any vertebral artery *** ultrasonography and angiography were performed and confirmed the presence of a dynamic occlusion of the vertebral artery V3-V4 segment when the head was rotated to the right secondary to left C1-C2 bone spur *** decompression led to complete resolution of paroxysmal symptoms without neurological *** BHS should be considered in cases of repeated posterior circulation transient ischaemic attack or ischaemic stroke,particularly when associated with high cervical spine abnormalities.

关键词： Bow hunter’s syndrome Stroke Non-invasive duplex ultrasonography Dynamic angiography Neurosurgery Case report

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