Document Detail

Bow hunter's syndrome caused by accessory cervical ossification: posterolateral decompression and the use of intraoperative Doppler ultrasonography.
MedLine Citation:
PMID:  17254879     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Bow hunter's syndrome refers to symptomatic vertebrobasilar insufficiency provoked by physiologic head rotation. CASE DESCRIPTION: We report a unique case of bow hunter's syndrome caused by an accessory cervical ossification and the first use of intraoperative Doppler ultrasonography directly upon the vertebral artery during the surgical repair. After a traumatic motor-vehicle collision, the patient developed recurrent syncopal episodes when he turned his head abruptly to the right. Transcranial Doppler studies and vertebral angiography with the patient's neck rotated into the symptomatic position revealed marked reduction of vertebral artery flow, and fine-cut CT of the upper cervical spine demonstrated the compressive accessory ossicle. Intraoperative Doppler ultrasound performed with the head in neutral and rotated positions, before and after surgical decompression, demonstrated restoration of blood flow in the vertebral artery. We discuss the mechanisms of bow hunter's syndrome and the advantages of intraoperative Doppler ultrasonography. CONCLUSION: This case describes the first use of intraoperative Doppler ultrasonography directly upon the vertebral artery to provide an unrestricted real-time assessment of the surgical decompression for bow hunter's syndrome.
Robert G Whitmore; Scott L Simon; Robert W Hurst; Harvey L Nisenbaum; Scott E Kasner; Eric L Zager
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2006-11-03
Journal Detail:
Title:  Surgical neurology     Volume:  67     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-26     Completed Date:  2007-03-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  169-71     Citation Subset:  IM    
Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
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MeSH Terms
Accidents, Traffic
Calcinosis / complications,  diagnosis,  surgery*
Cerebral Angiography
Cervical Vertebrae / abnormalities*,  radiography,  surgery
Decompression, Surgical / methods*
Middle Aged
Monitoring, Intraoperative / methods*
Neurosurgical Procedures / methods
Treatment Outcome
Ultrasonography, Doppler / methods*
Vascular Surgical Procedures / methods
Vertebral Artery / pathology,  surgery,  ultrasonography
Vertebrobasilar Insufficiency / etiology,  physiopathology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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