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Bow Hunter Syndrome
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Bow hunter stroke, positional occlusion of vertebral artery, rotational occlusion of vertebral artery
            • Definitions

              • Vertebrobasilar insufficiency secondary to mechanical occlusion or stenosis of vertebral artery during head rotation due to fibrous band or bony prominence

            IMAGING

            • General Features

              • CT Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • Gross Pathologic & Surgical Features

                        CLINICAL ISSUES

                        • Presentation

                          • Treatment

                            DIAGNOSTIC CHECKLIST

                            • Consider

                              • Image Interpretation Pearls

                                Selected References

                                1. Anaizi AN et al: Bow hunter's syndrome: the use of dynamic magnetic resonance angiography and intraoperative fluorescent angiography. J Neurosurg Spine. 20(1):71-4, 2014
                                2. Lu DC et al: Rotational vertebral artery occlusion-series of 9 cases. Neurosurgery. 67(4):1066-72; discussion 1072, 2010
                                3. Sugiu K et al: Endovascular treatment for bow hunter's syndrome: case report. Minim Invasive Neurosurg. 52(4):193-5, 2009
                                4. Whitmore RG et al: Bow hunter's syndrome caused by accessory cervical ossification: posterolateral decompression and the use of intraoperative Doppler ultrasonography. Surg Neurol. 67(2):169-71, 2007
                                5. Velat GJ et al: Intraoperative dynamic angiography to detect resolution of Bow Hunter's syndrome: Technical case report. Surg Neurol. 66(4):420-3; discussion 423, 2006
                                6. Horowitz M et al: Bow hunter's syndrome in the setting of contralateral vertebral artery stenosis: evaluation and treatment options. Spine (Phila Pa 1976). 27(23):E495-8, 2002
                                7. Seki T et al: Anterior decompression of the atlantoaxial vertebral artery to treat bow hunter's stroke: technical case report. Neurosurgery. 49(6):1474-6, 2001
                                8. Matsuyama T et al: Bow Hunter's stroke caused by a nondominant vertebral artery occlusion: case report. Neurosurgery. 41(6):1393-5, 1997
                                9. Matsuyama T et al: Comparison of C1-2 posterior fusion and decompression of the vertebral artery in the treatment of bow hunter's stroke. J Neurosurg. 86(4):619-23, 1997
                                10. Fox MW et al: Anterolateral decompression of the atlantoaxial vertebral artery for symptomatic positional occlusion of the vertebral artery. Case report. J Neurosurg. 83(4):737-40, 1995
                                11. Sorensen BF: Bow hunter's stroke. Neurosurgery. 2(3):259-61, 1978
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Pathology

                                      • Clinical Issues

                                        • Diagnostic Checklist

                                          TERMINOLOGY

                                          • Synonyms

                                            • Bow hunter stroke, positional occlusion of vertebral artery, rotational occlusion of vertebral artery
                                          • Definitions

                                            • Vertebrobasilar insufficiency secondary to mechanical occlusion or stenosis of vertebral artery during head rotation due to fibrous band or bony prominence

                                          IMAGING

                                          • General Features

                                            • CT Findings

                                              • Ultrasonographic Findings

                                                • Imaging Recommendations

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • Gross Pathologic & Surgical Features

                                                      CLINICAL ISSUES

                                                      • Presentation

                                                        • Treatment

                                                          DIAGNOSTIC CHECKLIST

                                                          • Consider

                                                            • Image Interpretation Pearls

                                                              Selected References

                                                              1. Anaizi AN et al: Bow hunter's syndrome: the use of dynamic magnetic resonance angiography and intraoperative fluorescent angiography. J Neurosurg Spine. 20(1):71-4, 2014
                                                              2. Lu DC et al: Rotational vertebral artery occlusion-series of 9 cases. Neurosurgery. 67(4):1066-72; discussion 1072, 2010
                                                              3. Sugiu K et al: Endovascular treatment for bow hunter's syndrome: case report. Minim Invasive Neurosurg. 52(4):193-5, 2009
                                                              4. Whitmore RG et al: Bow hunter's syndrome caused by accessory cervical ossification: posterolateral decompression and the use of intraoperative Doppler ultrasonography. Surg Neurol. 67(2):169-71, 2007
                                                              5. Velat GJ et al: Intraoperative dynamic angiography to detect resolution of Bow Hunter's syndrome: Technical case report. Surg Neurol. 66(4):420-3; discussion 423, 2006
                                                              6. Horowitz M et al: Bow hunter's syndrome in the setting of contralateral vertebral artery stenosis: evaluation and treatment options. Spine (Phila Pa 1976). 27(23):E495-8, 2002
                                                              7. Seki T et al: Anterior decompression of the atlantoaxial vertebral artery to treat bow hunter's stroke: technical case report. Neurosurgery. 49(6):1474-6, 2001
                                                              8. Matsuyama T et al: Bow Hunter's stroke caused by a nondominant vertebral artery occlusion: case report. Neurosurgery. 41(6):1393-5, 1997
                                                              9. Matsuyama T et al: Comparison of C1-2 posterior fusion and decompression of the vertebral artery in the treatment of bow hunter's stroke. J Neurosurg. 86(4):619-23, 1997
                                                              10. Fox MW et al: Anterolateral decompression of the atlantoaxial vertebral artery for symptomatic positional occlusion of the vertebral artery. Case report. J Neurosurg. 83(4):737-40, 1995
                                                              11. Sorensen BF: Bow hunter's stroke. Neurosurgery. 2(3):259-61, 1978