PDF(Pubmed)
Abstract：
BACKGROUND: Bow hunter\'s stroke (BHS) is a rare condition characterized by occlusion of the vertebral artery (VA) due to a head rotation. BHS typically results from neck hyperrotation, often due to anatomical factors. The authors present a case of BHS in a young male patient exacerbated by os odontoideum (OD), resulting in atlantoaxial dislocation, which ultimately led to VA dissection.
METHODS: A man in his 20s presented with persistent dizziness and nausea and initially received a diagnosis of a brain infarction. However, imaging revealed VA dissection caused by an OD with an associated synovial cyst. Surgical intervention, specifically atlantoaxial posterior fixation, resolved the instability and allowed for natural regression of the synovial cysts, preventing further vascular events. In this case, the OD with atlantoaxial dislocation was identified as the causative factor for BHS. The coexistence of a synovial cyst was a unique finding, likely triggered by chronic irritation caused by the OD.
CONCLUSIONS: This case emphasizes the importance of thorough cervical spinal evaluation in young patients presenting with posterior circulation stroke. https://thejns.org/doi/10.3171/CASE2487.
METHODS: A man in his 20s presented with persistent dizziness and nausea and initially received a diagnosis of a brain infarction. However, imaging revealed VA dissection caused by an OD with an associated synovial cyst. Surgical intervention, specifically atlantoaxial posterior fixation, resolved the instability and allowed for natural regression of the synovial cysts, preventing further vascular events. In this case, the OD with atlantoaxial dislocation was identified as the causative factor for BHS. The coexistence of a synovial cyst was a unique finding, likely triggered by chronic irritation caused by the OD.
CONCLUSIONS: This case emphasizes the importance of thorough cervical spinal evaluation in young patients presenting with posterior circulation stroke. https://thejns.org/doi/10.3171/CASE2487.
摘要：
背景：弓猎人中风（BHS）是一种罕见的疾病，其特征是由于头部旋转导致椎动脉（VA）闭塞。BHS通常是颈部过度旋转的结果，通常是由于解剖学因素。作者介绍了一例年轻男性患者的BHS病例，导致寰枢关节脱位，最终导致了VA解剖。
方法：一名20多岁的男子表现出持续的头晕和恶心，最初被诊断为脑梗塞。然而,影像学检查显示，由OD和相关的滑膜囊肿引起的VA夹层。手术干预,特别是寰枢椎后路固定，解决了不稳定，并允许滑膜囊肿自然消退，防止进一步的血管事件。在这种情况下,寰枢关节脱位的OD被确定为BHS的致病因素。滑膜囊肿的共存是一个独特的发现，可能是由OD引起的慢性刺激引起的。
结论：本病例强调了对年轻后循环卒中患者进行全面颈椎评估的重要性。https://thejns.org/doi/10.3171/CASE2487.
方法：一名20多岁的男子表现出持续的头晕和恶心，最初被诊断为脑梗塞。然而,影像学检查显示，由OD和相关的滑膜囊肿引起的VA夹层。手术干预,特别是寰枢椎后路固定，解决了不稳定，并允许滑膜囊肿自然消退，防止进一步的血管事件。在这种情况下,寰枢关节脱位的OD被确定为BHS的致病因素。滑膜囊肿的共存是一个独特的发现，可能是由OD引起的慢性刺激引起的。
结论：本病例强调了对年轻后循环卒中患者进行全面颈椎评估的重要性。https://thejns.org/doi/10.3171/CASE2487.
