Bow Hunter Syndrome Treated Via an Anterior Approach and Selective Decompression Only

Jung Hoon Kang¹, Soo Bin Im*¹, Je Hoon Jeong¹, Dong Seong Shin¹, Sang Mi Yang¹ and Jong Hyeon Mun²

Received:September 28, 2018;   Published: October 10, 2018

DOI: 10.26717/BJSTR.2018.09.001870

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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.

Keywords : Bow Hunter Syndrome; Rotational Vertebral Artery Syndrome; Anterior Decompression; Posterior Circulation Infarction; Nystagmus; Video nystagmography

Abbreviations : BHS: Bow Hunter Syndrome; BPPV: Benign Paroxysmal Positional Vertigo; CTA: Computed Tomography Angiography; DSA: Digital Subtraction Angiography; VA: Vertebral Artery; VNG: Video Nystagmo Graphy

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