与走行异常的椎动脉相关的弓状猎人综合征非典型病例：一例报告
Atypical case of bow hunter's syndrome linked to aberrantly coursing vertebral artery: A case report.
作者信息
Ahn Jun Hyong, Jun Hyo Sub, Kim In Kyeong, Kim Choong Hyo, Lee Seung Jin
机构信息
Department of Neurosurgery, Kangwon National University School of Medicine, Kangwon National University Hospital, Gangwon-do, Chuncheon-si 24289, South Korea.
出版信息
World J Clin Cases. 2023 Dec 16;11(35):8399-8403. doi: 10.12998/wjcc.v11.i35.8399.
BACKGROUND
In bow hunter's syndrome (BHS), also known as rotational vertebral artery (VA) syndrome, there is dynamic/rotational compression of the VA producing vertebrobasilar insufficiency. Most occurrences involve atlantoaxial rather than mid-cervical VA compromise, the latter being rarely reported. Herein, we detail successful VA decompression at mid-cervical spine, given a departure from its usual course.
CASE SUMMARY
The patient, a 45-year-old man, presented to our hospital with occipital headache and vertigo. Computed tomography angiography showed anomalous C4 entry of right VA, with compression upon head rotation to that side. Thyroid cartilage and anterior tubercle of C5 transverse process were visibly at fault. We opted for surgery, using an anterior cervical approach to remove the anterior tubercle. Patient recovery was uneventful and brought resolution of all preoperative symptoms.
CONCLUSION
BHS is an important consideration where aberrant coursing of VA and neurologic symptoms coexist.
背景
在弓状猎人综合征（BHS）中，也称为旋转椎动脉（VA）综合征，椎动脉存在动态/旋转性压迫，导致椎基底动脉供血不足。大多数病例涉及寰枢椎而非颈椎中段的椎动脉受压，后者很少被报道。在此，我们详细介绍了在颈椎中段成功进行椎动脉减压的病例，该椎动脉偏离了其正常走行。
病例摘要
患者为一名45岁男性，因枕部头痛和眩晕前来我院就诊。计算机断层扫描血管造影显示右侧椎动脉在C4水平进入异常，向该侧转头时受到压迫。可见甲状软骨和C5横突前结节有问题。我们选择手术治疗，采用颈椎前路入路切除前结节。患者恢复顺利，术前所有症状均得到缓解。
结论
当椎动脉走行异常与神经症状并存时，弓状猎人综合征是一个重要的考虑因素。
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