Parent Artery Embolization to Treat Bow Hunter’s Syndrome

Kimura, Masamune; Ohara, Nobuyuki; Fukuda, Tatsumaru; Imamura, Hirotoshi; Sakai, Nobuyuki; Kawamoto, Manabu

doi:10.1016/j.jvir.2022.02.007

Cited by 2 publications

(2 citation statements)

References 3 publications

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“…In some severe cases, surgical intervention may be required to correct the vertebral artery compression. Some patients achieve good results with interventional treatments [ 16 , 17 ]. In our case, the patient’s symptoms were relieved after restricting excessive twisting and stretching of the neck, in line with the current treatment principles.…”

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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“…5 With increasing numbers of applied mechanical thrombectomy and emergent vascular stenting, these cases may be observed more often in future. Interventional coil occlusion (as in patient 3 and 4) in the posterior circulation is known to be feasible in recurrent embolic stroke in cases of sufficient collateralization, 13,27 but is hence limited to subgroups only. A surgical bypass has been previously shown as a possible treatment option in selected patients with posterior ischemic stroke.…”

Section: Discussionmentioning

confidence: 99%

Bony Stroke: Ischemic Stroke Caused by Mechanical Stress on Brain Supplying Arteries From Anatomical Bone or Cartilage Anomalies

Haertl

Renz

Wunderlich

et al. 2023

Stroke

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Background: Bone or cartilage anomalies with affection of brain supplying arteries are a potential structural cause for ischemic stroke. In the following, we termed this entity bony stroke. Due to rarity of their description, there is no standardized workup and therapy for bony strokes. Methods: Retrospectively, we extracted diagnostic and therapeutic workup of all patients considered to have had a bony stroke between January 2017 to March 2022 at our comprehensive care center. Results: In total, 6 patients classified as a bony stroke were identified among 4200 acute patients with ischemic stroke treated during the study period. Each patient had recurrent ischemic strokes in the dependent vascular territory before diagnosis. Diagnosis was achieved by a combination of imaging devices, including sonography, computed tomography, and magnetic resonance imaging. In addition to conventional static imaging, the application of dynamic imaging modalities with the patients’ head in rotation or reclination confirmed a vessel affection following head movements in 3 patients (50%). Treatment options were interdisciplinary assessed and included the following: conservative treatment (n=1), endovascular stenting (n=2) or occlusion (n=2), surgical removal of bone/ cartilage (n=2), and surgical bypass treatment (n=1). In follow-up (mean 11.7 months), no patient experienced further ischemia. Conclusions: As a differential diagnosis, bony strokes may be considered in patients with recurrent ischemic stroke of unknown cause in one dependent vascular territory. Interdisciplinary evaluation and treatment may eliminate risk of stroke recurrence.

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Parent Artery Embolization to Treat Bow Hunter’s Syndrome

Cited by 2 publications

References 3 publications

Bilateral Bow Hunter Syndrome Associated with Loss of Cervical Physiological Curvature

Bilateral Bow Hunter Syndrome Associated with Loss of Cervical Physiological Curvature

Bony Stroke: Ischemic Stroke Caused by Mechanical Stress on Brain Supplying Arteries From Anatomical Bone or Cartilage Anomalies

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