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Bow hunter’s syndrome successfully treated with a posterior surgical decompression approach: A case report and review of literature
BACKGROUND: Bow hunter’s syndrome (BHS) is a rare but surgically treatable cause of vertebrobasilar insufficiency due to dynamic rotational occlusion of the vertebral artery. Typically, patients present with posterior circulation transient ischaemic symptoms such as presyncope, syncope, vertigo, dip...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Baishideng Publishing Group Inc
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9125276/ https://www.ncbi.nlm.nih.gov/pubmed/35663081 http://dx.doi.org/10.12998/wjcc.v10.i14.4494 |
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author | Orlandi, Niccolò Cavallieri, Francesco Grisendi, Ilaria Romano, Antonio Ghadirpour, Reza Napoli, Manuela Moratti, Claudio Zanichelli, Matteo Pascarella, Rosario Valzania, Franco Zedde, Marialuisa |
author_facet | Orlandi, Niccolò Cavallieri, Francesco Grisendi, Ilaria Romano, Antonio Ghadirpour, Reza Napoli, Manuela Moratti, Claudio Zanichelli, Matteo Pascarella, Rosario Valzania, Franco Zedde, Marialuisa |
author_sort | Orlandi, Niccolò |
collection | PubMed |
description | BACKGROUND: Bow hunter’s syndrome (BHS) is a rare but surgically treatable cause of vertebrobasilar insufficiency due to dynamic rotational occlusion of the vertebral artery. Typically, 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 described. CASE SUMMARY: A 70-year-old patient presented an acute onset of vertigo and gait instability triggered by right head rotation. His 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 vertebrae. Brain magnetic resonance imaging revealed the presence of acute bilateral cerebellar ischaemic lesions, while static vascular imaging did not reveal any vertebral artery abnormalities. Dynamic 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 compression. Surgical decompression led to complete resolution of paroxysmal symptoms without neurological sequelae. CONCLUSION: BHS should be considered in cases of repeated posterior circulation transient ischaemic attack or ischaemic stroke, particularly when associated with high cervical spine abnormalities. |
format | Online Article Text |
id | pubmed-9125276 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-91252762022-06-04 Bow hunter’s syndrome successfully treated with a posterior surgical decompression approach: A case report and review of literature Orlandi, Niccolò Cavallieri, Francesco Grisendi, Ilaria Romano, Antonio Ghadirpour, Reza Napoli, Manuela Moratti, Claudio Zanichelli, Matteo Pascarella, Rosario Valzania, Franco Zedde, Marialuisa World J Clin Cases Case Report BACKGROUND: Bow hunter’s syndrome (BHS) is a rare but surgically treatable cause of vertebrobasilar insufficiency due to dynamic rotational occlusion of the vertebral artery. Typically, 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 described. CASE SUMMARY: A 70-year-old patient presented an acute onset of vertigo and gait instability triggered by right head rotation. His 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 vertebrae. Brain magnetic resonance imaging revealed the presence of acute bilateral cerebellar ischaemic lesions, while static vascular imaging did not reveal any vertebral artery abnormalities. Dynamic 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 compression. Surgical decompression led to complete resolution of paroxysmal symptoms without neurological sequelae. CONCLUSION: BHS should be considered in cases of repeated posterior circulation transient ischaemic attack or ischaemic stroke, particularly when associated with high cervical spine abnormalities. Baishideng Publishing Group Inc 2022-05-16 2022-05-16 /pmc/articles/PMC9125276/ /pubmed/35663081 http://dx.doi.org/10.12998/wjcc.v10.i14.4494 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/ |
spellingShingle | Case Report Orlandi, Niccolò Cavallieri, Francesco Grisendi, Ilaria Romano, Antonio Ghadirpour, Reza Napoli, Manuela Moratti, Claudio Zanichelli, Matteo Pascarella, Rosario Valzania, Franco Zedde, Marialuisa Bow hunter’s syndrome successfully treated with a posterior surgical decompression approach: A case report and review of literature |
title | Bow hunter’s syndrome successfully treated with a posterior surgical decompression approach: A case report and review of literature |
title_full | Bow hunter’s syndrome successfully treated with a posterior surgical decompression approach: A case report and review of literature |
title_fullStr | Bow hunter’s syndrome successfully treated with a posterior surgical decompression approach: A case report and review of literature |
title_full_unstemmed | Bow hunter’s syndrome successfully treated with a posterior surgical decompression approach: A case report and review of literature |
title_short | Bow hunter’s syndrome successfully treated with a posterior surgical decompression approach: A case report and review of literature |
title_sort | bow hunter’s syndrome successfully treated with a posterior surgical decompression approach: a case report and review of literature |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9125276/ https://www.ncbi.nlm.nih.gov/pubmed/35663081 http://dx.doi.org/10.12998/wjcc.v10.i14.4494 |
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