Document Detail


Bowhunter's syndrome diagnosed with provocative digital subtraction cerebral angiography.
MedLine Citation:
PMID:  22275779     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Bowhunter's syndrome, also known as rotational occlusion of the vertebral artery, involves posterior circulation ischemia resulting from dynamic compromise of the dominant vertebral artery. This case highlights the importance of provocative digital subtraction angiography in making the diagnosis. A 41-year-old man presented for outpatient neurological evaluation for "lightheadedness" of several years' duration provoked by leftward head rotation. The only abnormality identified on initial magnetic resonance angiography was atresia of the nondominant left vertebral artery. Conventional digital subtraction angiography (DSA) followed by provocative DSA revealed development of a dynamic stenosis of the right vertebral artery involving the extraforaminal segment just superior to the C1 vertebra. Noncontrast computed tomography of the cervical spine confirmed ossification of the posterior right atlanto-occipital membrane leading to a near complete bony arcuate foramen. Following neurosurgical decompression, the patient demonstrated complete resolution of all neurologic symptoms. Bowhunter's syndrome is a unique clinical entity that must be considered in the evaluation of patients with symptoms of posterior circulation ischemia. Provocative DSA remains the preferred modality for definitive diagnosis.
Authors:
William B Taylor; Clayton L Vandergriff; Michael J Opatowsky; Kennith F Layton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Proceedings (Baylor University. Medical Center)     Volume:  25     ISSN:  0899-8280     ISO Abbreviation:  Proc (Bayl Univ Med Cent)     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9302033     Medline TA:  Proc (Bayl Univ Med Cent)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  26-7     Citation Subset:  -    
Affiliation:
Department of Radiology, Baylor University Medical Center at Dallas.
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