Article ID: 10974
A 71-year-old woman presented to our care facility with complaints of diplopia and nausea when she rotated her head to the right side. She was neurologically intact and denied experiencing the symptoms when she rotated her head to the left side. Head MRI diffusion-weighted image showed a high-intensity spot in the cerebellum. MR angiography showed hypoplasia of the right vertebral artery (VA). However, the causes of the cerebellar infarction were not detected. We considered the possibility of bow hunter’s syndrome and performed ultrasonography during head rotation. However, this failed to detect the flow impairment of VA. Finally, digital subtraction angiography was performed and it was found that the left VA was occluded at the C1-2 level when she rotated the head to the right side. Digital subtraction angiography kymography was useful for the diagnosis of bow hunter’s syndrome.
