Journals on Neuro Imaging - BJSTR Journal

Abstract

We present the case of a 38-year-old male who complained of repeated dizziness and syncope. Bow hunter syndrome (BHS) was diagnosed via computed tomography angiography (CTA) and three-position digital subtraction #angiography (DSA). In the neutral position, CTA and DSA revealed left vertebral artery (VA) stenosis at the C2 transverse foramen and right VA #hypoplasia. When the head was turned to the right, DSA showed that blood flow decreased at the C3-4 level and stopped at the C2 level. The bony structure around the VA at the C2 transverse foramen was decompressed via an anterior surgical approach, and the symptoms resolved. This case indicates that the stenotic point associated with BHS should be determined its exact stenotic point and surgical treatment should be individualized based on the #stenotic point.Dizziness triggered by rotating the head is a characteristic symptom of BHS. However, dizziness has many causes, and patients who complain of dizziness provoked by rotating the head should also be evaluated in terms of a peripheral disorder, such as benign #paroxysmal positional vertigo (BPPV). General nystagmus and #videonystagmography (VNG) are useful to rule out a peripheral disorder, allowing BHS diagnosis via identification of the characteristic nystagmus [1,2]. There are various treatment options, ranging from conservative treatment such as rehabilitation to surgery [3].

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Bow Hunter Syndrome Treated Via an Anterior Approach and Selective Decompression Only by Soo Bin Im in BJSTR

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