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Updated: May 22, 2026
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Portable Thermographic Screening for Detection of Acute Wallenberg's Syndrome
Published on: September 19, 2019
Bow hunter's syndrome after contralateral vertebral artery dissection
Yoshitaka Yamaguchi1, Hikaru Nagasawa, Tatsushi Yamakawa
1Department of Neurology, Yamagata Prefectural Central Hospital, Yamagata, Japan. y.yamaguchi830@gmail.com
Summary
Bow hunter's syndrome, a cause of transient vertebrobasilar insufficiency, occurred after contralateral vertebral artery dissection. This unique case highlights a failure in compensatory blood flow, leading to symptoms upon neck rotation.
Area of Science:
- Neurology
- Vascular Surgery
Background:
- Bow hunter's syndrome involves transient vertebrobasilar insufficiency triggered by neck rotation.
- Causes include osteophytes, tumors, fibrous bands, infection, and trauma.
Observation:
- A patient presented with nuchal pain, diagnosed as left vertebral artery (VA) dissection.
- The patient experienced faintness when turning his neck left post-dissection.
Findings:
- Digital subtraction angiography showed right VA stenosis at C2 upon left neck rotation, progressing to complete occlusion.
- This was diagnosed as Bow hunter's syndrome, attributed to failed compensatory blood flow from the contralateral (left) VA dissection.
Implications:
- This is the first reported case of Bow hunter's syndrome secondary to contralateral vertebral artery dissection.
- It underscores the importance of assessing compensatory blood flow in cases of VA dissection presenting with positional symptoms.
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