Atypical case of bow hunter's syndrome linked to aberrantly coursing vertebral artery: A case report.

Bow hunter’s syndrome Case report Vertebral artery Vertebrobasilar insufficiency

Journal

World journal of clinical cases
ISSN: 2307-8960
Titre abrégé: World J Clin Cases
Pays: United States
ID NLM: 101618806

Informations de publication

Date de publication:
16 Dec 2023
Historique:
received: 13 09 2023
revised: 27 11 2023
accepted: 06 12 2023
medline: 22 12 2023
pubmed: 22 12 2023
entrez: 22 12 2023
Statut: ppublish

Résumé

In bow hunter's syndrome (BHS), also known as rotational vertebral artery (VA) syndrome, there is dynamic/rotational compression of the VA producing vertebrobasilar insufficiency. Most occurrences involve atlantoaxial rather than mid-cervical VA compromise, the latter being rarely reported. Herein, we detail successful VA decompression at mid-cervical spine, given a departure from its usual course. The patient, a 45-year-old man, presented to our hospital with occipital headache and vertigo. Computed tomography angiography showed anomalous C4 entry of right VA, with compression upon head rotation to that side. Thyroid cartilage and anterior tubercle of C5 transverse process were visibly at fault. We opted for surgery, using an anterior cervical approach to remove the anterior tubercle. Patient recovery was uneventful and brought resolution of all preoperative symptoms. BHS is an important consideration where aberrant coursing of VA and neurologic symptoms coexist.

Sections du résumé

BACKGROUND BACKGROUND
In bow hunter's syndrome (BHS), also known as rotational vertebral artery (VA) syndrome, there is dynamic/rotational compression of the VA producing vertebrobasilar insufficiency. Most occurrences involve atlantoaxial rather than mid-cervical VA compromise, the latter being rarely reported. Herein, we detail successful VA decompression at mid-cervical spine, given a departure from its usual course.
CASE SUMMARY METHODS
The patient, a 45-year-old man, presented to our hospital with occipital headache and vertigo. Computed tomography angiography showed anomalous C4 entry of right VA, with compression upon head rotation to that side. Thyroid cartilage and anterior tubercle of C5 transverse process were visibly at fault. We opted for surgery, using an anterior cervical approach to remove the anterior tubercle. Patient recovery was uneventful and brought resolution of all preoperative symptoms.
CONCLUSION CONCLUSIONS
BHS is an important consideration where aberrant coursing of VA and neurologic symptoms coexist.

Identifiants

pubmed: 38130620
doi: 10.12998/wjcc.v11.i35.8399
pmc: PMC10731192
doi:

Types de publication

Case Reports

Langues

eng

Pagination

8399-8403

Informations de copyright

©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

Auteurs

Jun Hyong Ahn (JH)

Department of Neurosurgery, Kangwon National University School of Medicine, Kangwon National University Hospital, Gangwon-do, Chuncheon-si 24289, South Korea.

Hyo Sub Jun (HS)

Department of Neurosurgery, Kangwon National University School of Medicine, Kangwon National University Hospital, Gangwon-do, Chuncheon-si 24289, South Korea.

In Kyeong Kim (IK)

Department of Neurosurgery, Kangwon National University School of Medicine, Kangwon National University Hospital, Gangwon-do, Chuncheon-si 24289, South Korea.

Choong Hyo Kim (CH)

Department of Neurosurgery, Kangwon National University School of Medicine, Kangwon National University Hospital, Gangwon-do, Chuncheon-si 24289, South Korea.

Seung Jin Lee (SJ)

Department of Neurosurgery, Kangwon National University School of Medicine, Kangwon National University Hospital, Gangwon-do, Chuncheon-si 24289, South Korea. rabbit3540@empas.com.

Classifications MeSH