Shimizu T, Waga S, Kojima T, Niwa S
Department of Neurosurgery, Mie University Medical School, Japan.
J Neurosurg. 1988 Jul;69(1):127-31. doi: 10.3171/jns.1988.69.1.0127.
A case of cerebellar infarction induced by repeated neck rotation ("bow-hunter's stroke") is reported. The most likely mechanism is that repeated rotational neck movement brings about thickening of the atlanto-occipital membrane, fixing the vertebral artery in the vascular groove of the atlas. The vertebral artery is thus pinched at the time of neck rotation, leading to thrombus formation. Embolization results in cerebellar infarction. Surgical decompression of the vertebral artery at the level of the atlas in this case relieved the symptoms, and postoperative angiography demonstrated good flow within the vertebral artery even when the neck was rotated. It was not necessary to restrict the patient's neck movement postoperatively.
本文报道了一例因反复颈部旋转诱发的小脑梗死（“弓猎者卒中”）。最可能的机制是反复的颈部旋转运动导致寰枕膜增厚，将椎动脉固定在寰椎的血管沟内。因此，在颈部旋转时椎动脉受到挤压，导致血栓形成。栓子形成导致小脑梗死。在该病例中，对寰椎水平的椎动脉进行手术减压缓解了症状，术后血管造影显示即使颈部旋转时椎动脉内血流也良好。术后无需限制患者的颈部活动。
