Bow Hunter Syndrome

This pathology interested me because of the name Bow Hunter's Syndrome. My husband is a bow hunter, so it caught my attention. It is when the vertebrobasilar artery is occluded or there is stenosis of one VA. It can occur at any level of the cervical spine. Certain spinal abnormalities, like osteophytes, put pressure on the vertebral arteries at the back of the upper neck where the arteries enter the brain. This results in the blood flow being compromised to the brain which can result in a stroke. It is usually caused by a certain head rotation which causes the VA to be susceptible to compression by muscles,fibrous ligaments or other bone structures during a particular rotation of the head. Apparently, in 1978 Dr. Sorensen had a patient who showed vertibrobasilar insufficiency when practicing archery, thus the name Bow Hunter's Syndrome.
Symptoms include headaches, nausea, vomiting, blurred vision, deafness, dizziness, syncope, vertigo and "drop attacks" which are episodes of falling to the ground without losing consciousness.

3-D CTA, Computed Tomography Angiography and/or MRA, Magnetic Resonance Angiography are two methods in diagnosing Bow Hunter's Syndrome. Studies have found that 3-D CTA has several benefits in diagnosing and treatment options. It allows great visualization of the anatomical relationship between vascular lesions and surrounding bone structures. It provides multiple projections of the anatomic complexity of the vascular structures. It also provides useful information regarding surgical options and approaches.

Neck immobilization is sometimes used for treatment. The downfall to this is the restrictions of lifestyle for the patient. Direct surgical decompression is usually the treatment of choice to try and alleviate the symptoms as well as the problem.