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Bow Hunter Syndrome with Associated Pseudoaneurysm.

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Summary

Bow hunter syndrome, a vertebral artery compression, can cause dizziness and syncope. Surgical stabilization effectively treated a unique case complicated by a vertebral artery pseudoaneurysm.

Keywords:
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Area of Science:

  • Neurology
  • Vascular Surgery
  • Neurosurgery

Background:

  • Bow hunter syndrome involves vertebral artery compression during head rotation, causing transient vertebrobasilar insufficiency.
  • Symptoms include syncope, vertigo, dizziness, and visual disturbances, resolving with neutral head position.
  • Treatment options range from surgical decompression to endovascular interventions.

Observation:

  • A 49-year-old female presented with neck pain, vertigo, and near syncope upon specific head movements.
  • Computed tomography angiography revealed a V3 pseudoaneurysm and near-total left vertebral artery occlusion.
  • These findings were position-dependent, occurring when the head was turned up and right.

Findings:

  • The patient underwent successful computed tomography-navigated posterior instrumentation with C1 lateral mass and C2 translaminar screws.
  • Bilateral intrafacet cages were used to promote segmental fusion.
  • Postoperatively, the patient experienced no neurological deficits or recurrent symptoms.

Implications:

  • This case highlights a rare presentation of bow hunter syndrome complicated by a vertebral artery pseudoaneurysm.
  • Surgical stabilization proved effective in treating this complex vascular and mechanical issue.
  • The findings underscore the importance of anatomical stabilization for complex vertebral artery compression syndromes.