Bow hunter syndrome: A rare yet important etiology of posterior circulation stroke

•BHS should be suspected in a patient with unexplained vertebral artery dissection.•An underlying genetic etiology should be considered in children with BHS. A6-year-oldgirl presented with acute-onset headache andfluctuating right-sided weakness.HerPedNIHSSwas13. Brain MRI/MRA showed acute pontine a...

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Bibliographic Details
Published inJournal of clinical neuroscience Vol. 78; pp. 418 - 419
Main Authors Qashqari, Hebah, Bhathal, Ishvinder, Pulcine, Elizabeth, Muthusami, Prakash, Moharir, Mahendranath, MacGregor, Daune, Kulkarni, Abhaya, Dlamini, Nomazulu
Format Journal Article
LanguageEnglish
Published Elsevier Ltd 01.08.2020
Subjects
Bow hunter’s syndrome
Dissection
Pediatric stroke
Posterior circulation
Rotational vertebral artery syndrome
Vertebral artery
Vertebrobasilar insufficiency
Pediatric stroke
Vertebral artery
Bow hunter’s syndrome
Posterior circulation
Dissection
Vertebrobasilar insufficiency
Rotational vertebral artery syndrome
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Summary:•BHS should be suspected in a patient with unexplained vertebral artery dissection.•An underlying genetic etiology should be considered in children with BHS. A6-year-oldgirl presented with acute-onset headache andfluctuating right-sided weakness.HerPedNIHSSwas13. Brain MRI/MRA showed acute pontine arterial ischemic stroke(AIS)and remote right cerebellar and thalamic infarcts.No antecedent trauma or other stroke risk factors were identified. Clinical suspicion of bow hunter syndromewas raised. CTshowed congenital C2-C3 fusion and dynamic angiogramconfirmed the diagnosis. The management challenges of this rare condition are discussed below.
ISSN:0967-5868
1532-2653
DOI:10.1016/j.jocn.2020.04.110