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Recurrent juvenile ischemic stroke caused by bow hunter's stroke revealed by carotid duplex ultrasonography

Hidehiro Takekawa1,2, Keisuke Suzuki3, Takahito Nishihira1

  • 1Stroke Division, Department of Neurology, Dokkyo Medical University, Tochigi, Japan.

Journal of Medical Ultrasonics (2001)
|November 19, 2015
PubMed

Bow hunter's stroke (BHS) is a rare cause of vertebrobasilar insufficiency due to rotational vertebral artery (VA) occlusion associated with head turning. We report a juvenile patient presenting with recurrent ischemic stroke caused by BHS, which was revealed by carotid duplex ultrasonography. Carotid duplex ultrasonography performed in the neutral position showed normal findings. However, disappearance of end-diastolic blood flow of contralateral VAs was observed with head rotation. Digital subtraction angiography confirmed occlusion at C1/2 levels in the VA contralateral to the head rotation, bilaterally. Importantly, our patient did not recognize the association of head rotation and previous episodes of stroke. We suggest that BHS should be considered in patients with cryptogenic stroke occurring in the vertebrobasilar artery territory.

Keywords:
Bow hunter’s strokeCarotid duplex ultrasonographyJuvenile ischemic stroke

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