Meier Tristan G, Akinduro Oluwaseun O, Torabi Radmehr, Gokaslan Ziya L
Mayo Clinic Alix School of Medicine, Jacksonville, Florida.
Mayo Clinic Department of Neurologic Surgery, Jacksonville, Florida.
J Neurosurg Case Lessons. 2024 Dec 23;8(26). doi: 10.3171/CASE24415.
Rotational vertebral artery occlusion, or bow hunter's syndrome (BHS), is a rare but clinically important cause of vertebrobasilar insufficiency. Extrinsic compression of the artery is usually caused by osteophytes, fibrous bands, or lateral disc herniation and typically occurs in the setting of anatomical variations, leading to dynamic compromise of the posterior circulation. Neoplastic causes of BHS are rare.
The authors present the case of a 72-year-old man with a left vertebral artery-dominant posterior circulation and isolated small right vertebral artery terminating in the posterior inferior cerebellar artery (PICA). He developed progressively worsening dynamic insufficiency of his right PICA circulation due to compression of the right vertebral artery at C2 from an intradural-extradural dumbbell-shaped lesion. This patient was successfully treated via surgical debulking of the lesion and cervical spine fixation and experienced no neurological deficits postoperatively.
This neoplastic change represents an exceedingly rare presentation for BHS, which warrants further study on its etiology and treatment. https://thejns.org/doi/10.3171/CASE24415.
旋转性椎动脉闭塞，即弓状猎人综合征（BHS），是椎基底动脉供血不足的一种罕见但具有临床重要性的病因。动脉的外在压迫通常由骨赘、纤维带或外侧椎间盘突出引起，且通常发生在解剖变异的情况下，导致后循环的动态受损。BHS的肿瘤性病因较为罕见。
作者报告了一例72岁男性病例，其为左侧椎动脉优势型后循环，孤立的小右侧椎动脉终止于小脑后下动脉（PICA）。由于C2水平的右侧椎动脉受到硬膜内-硬膜外哑铃形病变的压迫，他出现了右侧PICA循环进行性加重的动态供血不足。该患者通过手术切除病变并进行颈椎固定成功治疗，术后未出现神经功能缺损。
这种肿瘤性改变是BHS极为罕见的表现，这值得对其病因和治疗进行进一步研究。https://thejns.org/doi/10.3171/CASE24415 。
