Bow Hunter’s Syndrome

Regenhardt, Robert W; Kozberg, Mariel G.; Dmytriw, Adam A; Vranic, Justin E; Stapleton, Christopher J.; Silverman, Scott

doi:10.1161/strokeaha.121.037253

Cited by 9 publications

(6 citation statements)

References 10 publications

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“…Currently, DSA is considered the criterion standard for diagnosing bow hunter syndrome. This invasive examination allows for the visualization of vascular conditions, specific compression sites, and collateral circulation in both neutral and head-turned positions [ 10 ]. However, it is important to consider that DSA may not be suitable for all patients due to contraindications.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Bow Hunter Syndrome Associated with Loss of Cervical Physiological Curvature

Wang,

Bi,

Chen

2024

Am J Case Rep

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Patient: Female, 25-year-old Final Diagnosis: Bow-Hunter syndrome Symptoms: Dizziness • nausea • vertigo • vomiting Clinical Procedure: — Specialty: Neurology • Neurosurgery • Sports Medicine Objective: Rare disease Background: Bow hunter syndrome is a rare disease that is often overlooked. It presents with complex and variable clinical symptoms and causes, making diagnosis and treatment challenging. This case report focuses on a young patient with bilateral bow hunter syndrome, possibly caused by the loss of cervical physiological curvature. The aim is to enhance understanding and awareness of the disease. It is important to consider the possibility of bow hunter syndrome in young patients with long-term poor neck posture and symptoms such as dizziness, nausea, vomiting, and neck rotation-related symptoms. In such cases, thorough examination of posterior circulation hemodynamics and vascular morphology is recommended. Case Report: A 25-year-old woman was admitted to the hospital mainly because of “dizziness for 10 hours.” The dizziness was aggravated when the right side of the neck was turned and the body position changed. This was accompanied by visual rotation, nausea, and vomiting. Bow hunter syndrome was diagnosed based on the clinical symptoms and hemodynamic examination of the posterior circulation. The patient was given a cervical collar to limit excessive twisting of the neck and instructed to avoid large-angle deflection of the neck after discharge. During the 3-month follow-up, no characteristic symptoms (such as dizziness) reappeared. Conclusions: Bow hunter syndrome is a rare clinical posterior circulation compression syndrome with complex etiology. This case suggests that the simple disappearance of cervical curvature may be related to the occurrence of bow hunter syndrome. The dynamic monitoring of blood flow by color Doppler ultrasound and transcranial Doppler in different head positions provides clear clues to suspected bow hunter syndrome. With the help of computed tomography angiography, the diagnosis of bow hunter syndrome may be obtained by noninvasive examination.

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Section: Discussionmentioning

confidence: 99%

Bilateral Bow Hunter Syndrome Associated with Loss of Cervical Physiological Curvature

Wang,

Bi,

Chen

2024

Am J Case Rep

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“…Although HBHS is thought to be a subtype of Bow Hunter's syndrome (BHS), there are many differences between the two conditions. HBHS tends to involve lower cervical vertebral (C5-7) levels (5/6, 87%), while the C1/2 levels are typically affected in BHS ( 6 , 7 ). Transient vertebrobasilar insufficiency symptoms associated with neck rotation, typically seen in BHS ( 6 ), are uncommon in HBHS (1/5, 20%), and HBHS causes stroke recurrence (5/6, 86%), which may be refractory to antiplatelet therapy (3/5, 60%).…”

Section: Discussionmentioning

confidence: 99%

Hidden Bow Hunter's Syndrome Diagnosed Using Dynamic Cerebral Angiography and Successfully Treated with Spinal Surgery: A Case Report and Review of the Literature

et al. 2024

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Hidden bow hunter's syndrome (HBHS) is a rare disease in which the vertebral artery (VA) occludes in a neutral position but recanalizes in a particular neck position. We herein report an HBHS case and assess its characteristics through a literature review. A 69-year-old man had repeated posterior-circulation infarcts with right VA occlusion. Cerebral angiography showed that the right VA was recanalized only with neck tilt. Decompression of the VA successfully prevented stroke recurrence. HBHS should be considered in patients with posterior circulation infarction with an occluded VA at its lower vertebral level. Diagnosing this syndrome correctly is important for preventing stroke recurrence.

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“…Compression can be caused primarily by adjacent osteophytes, fibrous bands, herniated disc, tumors or secondarily due to post-intervention or trauma. [97][98][99] Aggravating factors include hypoplasia or stenosis of the contralateral vertebral artery. 100 Depending on the level of posterior circulation insufficiency, symptoms can either be transient or persistent, varying from presyncope or syncope to strokes.…”

Section: Bow Hunter Syndromementioning

confidence: 99%

Compressive lesions of the head and neck: Common and uncommon must-know entities

et al. 2023

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There are many lesions that cause compression of nerves and vessels in the head and neck, and they can often be overlooked in the absence of adequate history or if not suspected by the radiologist. Many of these lesions require a high index of suspicion and optimal positioning for imaging. While a multimodality approach is critical in the evaluation of compressive lesions, an MRI utilizing high-resolution (heavily weighted) T2-weighted sequence is extremely useful as a starting point. In this review, we aim to discuss the radiological features of the common and uncommon compressive lesions of the head and neck which are broadly categorized into vascular, osseous, and miscellaneous etiologies.

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Bow Hunter’s Syndrome

Cited by 9 publications

References 10 publications

Bilateral Bow Hunter Syndrome Associated with Loss of Cervical Physiological Curvature

Bilateral Bow Hunter Syndrome Associated with Loss of Cervical Physiological Curvature

Hidden Bow Hunter's Syndrome Diagnosed Using Dynamic Cerebral Angiography and Successfully Treated with Spinal Surgery: A Case Report and Review of the Literature

Compressive lesions of the head and neck: Common and uncommon must-know entities

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