Service de Neurochirurgie, Hôpital Lariboisière, Université Paris VII, Paris, France.
Neurosurg Rev. 2012 Jan;35(1):127-35; discussion 135. doi: 10.1007/s10143-011-0343-4. Epub 2011 Jul 26.
Bow hunter's syndrome (BHS) is defined as symptomatic, vertebro-basilar insufficiency caused by mechanical occlusion of the vertebral artery (VA) at the atlanto-axial level during head rotation. In the literature, about 40 cases have been reported. However, due to the rarity of this pathology, there are no guidelines for diagnosis and treatment. Conservative, surgical, and endovascular concepts have been proposed. In order to work out an algorithm, we performed a systematic review of the literature and a retrospective analysis of patients, which have been treated in our institutions over the last decade. The clinical series was comprised of five patients. The symptoms ranged from transient vertigo to posterior circulation stroke. Diagnosis was established by dynamic angiography. In all patients, the VA was decompressed; one patient required additional fusion. The clinical and radiological results were good, and the treatment-related morbidity was low. The literature review demonstrated that Bow hunter's syndrome is a rare pathology but associated with a pathognomonic and serious clinical presentation. The gold standard of diagnosis is dynamic angiography, and patients were well managed with tailored vertebral artery decompression. By this management, clinical and radiological results were excellent and the treatment-related morbidity was low.
弓型狩猎者综合征（BHS）定义为：在头部旋转时，由于寰枢椎水平椎动脉（VA）的机械性闭塞引起的有症状的椎基底动脉不足。在文献中，约有 40 例报道。然而，由于该病理的罕见性，尚无诊断和治疗指南。保守、手术和血管内概念已经被提出。为了制定一个算法，我们对文献进行了系统回顾，并对过去十年在我们机构治疗的患者进行了回顾性分析。临床系列包括五名患者。症状从短暂的眩晕到后循环中风不等。通过动态血管造影术确诊。在所有患者中，VA 都得到了减压；一名患者需要额外的融合。临床和影像学结果良好，治疗相关的发病率较低。文献回顾表明，弓型狩猎者综合征是一种罕见的病理，但与特征性和严重的临床表现有关。诊断的金标准是动态血管造影，通过针对性的椎动脉减压可以很好地管理患者。通过这种治疗，临床和影像学结果都很好，治疗相关的发病率也较低。
