25/08/2025
Glad to share an interesting and rare case treated surgically.
*Bow Hunter Syndrome*
A young female presented with c/o recurrent Posterior circulation infarcts. Her neck movements precipitated episodes of vertigo and dizziness which resolved spontaneously within minutes.
Ct angio suggested compression of Right Vertebral Artery at level of C1 posterior arch (Vertebral Artery groove was compromised).
Surgery (C1 Right Hemilaminectomy + Vertebral Artery Decompression) was done.
Post surgery Patient is symptom free and angio showed complete resolution of normal diameter of Vertebral artery.
1. Right PICA territory infarct.
2. Attenauted Right Vertebral Artery in Sulcus Arteriosus distal to Foramen Transversarium.
3. Bony tubercle from posterior arch of C1 compressing vertebral artery.
4,5. Post-op ct angio showing complete restoration of normal diameter of vertebral artery.
Such rare cases demand a team effort for diagnosis, management and deciding follow-up treatment. Huge thanks to Dr. Anmol Singh Rai and Dr. Isha Sharma