Hidden Bow Hunter's Syndrome Diagnosed Using Dynamic Cerebral Angiography and Successfully Treated with Spinal Surgery: A Case Report and Review of the Literature

Satoshi Miyamoto; Mikito Hayakawa; Sho Okune; Ryosuke Shintoku; Akinari Yamano; Takato Hiramine; Toshihide Takahashi; Hisayuki Hosoo; Yoshiro Ito; Aiki Marushima; Masao Koda; Eiichi Ishikawa; Yuji Matsumaru

doi:10.2169/internalmedicine.1386-22

This article has now been updated. Please use the final version.

Hidden Bow Hunter's Syndrome Diagnosed Using Dynamic Cerebral Angiography and Successfully Treated with Spinal Surgery: A Case Report and Review of the Literature

Satoshi Miyamoto, Mikito Hayakawa, Sho Okune, Ryosuke Shintoku, Akinari Yamano, Takato Hiramine, Toshihide Takahashi, Hisayuki Hosoo, Yoshiro Ito, Aiki Marushima, Masao Koda, Eiichi Ishikawa, Yuji Matsumaru

Author information

Satoshi Miyamoto
Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
Mikito Hayakawa
Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
Division of Stroke Prevention and Treatment, Faculty of Medicine, University of Tsukuba, Japan
Sho Okune
Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
Ryosuke Shintoku
Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
Akinari Yamano
Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
Takato Hiramine
Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
Toshihide Takahashi
Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
Hisayuki Hosoo
Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
Yoshiro Ito
Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
Aiki Marushima
Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
Masao Koda
Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Japan
Eiichi Ishikawa
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
Yuji Matsumaru
Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
Division of Stroke Prevention and Treatment, Faculty of Medicine, University of Tsukuba, Japan

Keywords: Hidden bow hunter's syndrome, Bow hunter's syndrome, posterior circulation infarction, stroke causes

JOURNAL OPEN ACCESS Advance online publication

Article ID: 1386-22

DOI https://doi.org/10.2169/internalmedicine.1386-22

The final version of this article is now available: Vol. 63 (2024), No. 2 pp. 327-331

Details

Abstract

Hidden bow hunter's syndrome (HBHS) is a rare disease in which the vertebral artery (VA) occludes in a neutral position but recanalizes in a particular neck position. We herein report an HBHS case and assess its characteristics through a literature review. A 69-year-old man had repeated posterior-circulation infarcts with right VA occlusion. Cerebral angiography showed that the right VA was recanalized only with neck tilt. Decompression of the VA successfully prevented stroke recurrence. HBHS should be considered in patients with posterior circulation infarction with an occluded VA at its lower vertebral level. Diagnosing this syndrome correctly is important for preventing stroke recurrence.

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