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Vol.58 No.4 >

Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/317

Title: A CASE OF BOW HUNTER'S STROKE PRESENTING SYNCOPE AS AN INITIAL SYMPTOM WHILE DRJVING
Authors: Takeshima, Yasuhiro
Kawata, Kazumro
Imanishi, Kazumi
Kawaguchi, Shoichiro
Tamaki, Ryo
Nakase, Hiroyuki
Sakaki, Toshisuke
Hoshida, Tohru
Keywords: Bow Hunter's Stroke
syncope
traffic accident
posterior fusion
Issue Date: 31-Aug-2007
Publisher: 奈良医学会
奈良県立医科大学
Citation: Journal of Nara Medical Association Vol.58 No.4 p.135-139
Abstract: Bow Hunter's Stroke is a consequence of vertebrobasilar insufficiency as a result of mechanical occlusion or stenosis of the vertebral artery at the C1-C2 level by head rotation. It is rarely symptomatic in daily activities. We describe a case of Bow Hunter's Stroke(BHS) presenting syncope as an initial symptom while driving a car. A 59-year-old male patient suddenly lost consciousness while driving and his car dropped into a ravine 20 meters deep. On admission he was conscious, but suffering Central Cord Syndrome (CCS). We examined the cause of syncope. At the time of the accident, he turned his head to the rear in order to back his car and lost consciousness. Magnetic resonance angiography demonstrated the dominant vertebral artery (VA) in the left and the hypoplastic VA in the right. Cerebral angiography on turning the head 90 degrees to the right revealed the left VA occluded at the C1-C2 level. Therefore we diagnosed the patient with BHS. The vertigo symptom was intractable with conservative treatment, and we therefore performed C1-C2 posterior fusion. The post-operative course was uneventfu1 and he does not have the symptoms anymore. Syncope sometimes induces traffic accidents, but it is rare that BHS is detected on examination of common trauma. Therefore when vertigo, dizziness, or syncope is found in common trauma, BHS must be considered as a potential cause.
URI: http://hdl.handle.net/10564/317
ISSN: 13450069
Appears in Collections:Vol.58 No.4

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