PDF(Pubmed)
Abstract：
Bow Hunter\'s syndrome (BHS) is an uncommon condition characterized by impingement of one of the two vertebral arteries induced by cervical rotation, causing symptomatic vertebrobasilar insufficiency of the posterior cerebral circulation. We report a case of BHS in an 84-year-old male. Two months following a motor vehicle accident, the patient presented to an urgent care facility with subsequent transfer to the emergency department with complaints of lightheadedness upon right-lateral head movement. A cerebral angiogram demonstrated mild focal stenosis in the dominant left vertebral artery at the C2 level when in neutral position with significant worsening of the stenosis in the right-lateral head position with absent anterograde flow, consistent with BHS. Resultantly, the patient was referred for neurosurgery and successfully underwent placement of right-sided C2-C4 postero-lateral instrumentation and left-sided C2-C3 laminar screws projected towards the right side. This case highlights the importance of imaging in BHS diagnosis and guidance for treatment, as well as the need for a surgical standard of care for BHS patients.
摘要：
弓亨特综合征（BHS）是一种罕见的疾病，其特征是颈椎旋转引起的两个椎动脉之一的撞击，引起大脑后循环的症状性椎基底动脉供血不足。我们报告了一名84岁男性的BHS病例。机动车事故发生两个月后，该患者被送往紧急护理机构，随后被转移到急诊科，并抱怨右侧头部移动时头昏眼花。脑血管造影显示，当处于中立位置时，在C2水平的优势左侧椎动脉中存在轻度局灶性狭窄，而在右侧头部位置的狭窄明显恶化，没有顺行血流。与BHS一致。结果，患者被转介接受神经外科手术,并成功置入右侧C2-C4后外侧器械和向右侧投射的左侧C2-C3椎板螺钉.该病例突出了影像学在BHS诊断和指导治疗中的重要性,以及需要BHS患者的手术护理标准。
