Bow Hunter's Syndrome after Contralateral Vertebral Artery Dissection

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Bow Hunter's Syndrome after Contralateral Vertebral Artery Dissection Yoshitaka Yamaguchi, MD, Hikaru Nagasawa, MD, PhD, Tatsushi Yamakawa, MD, Takeo Kato, MD, PhD Journal of Stroke and Cerebrovascular Diseases Volume 21, Issue 8, Pages 916.e7-916.e9 (November 2012) DOI: 10.1016/j.jstrokecerebrovasdis.2012.04.003 Copyright © 2012 National Stroke Association Terms and Conditions

Figure 1 Magnetic resonance imaging scan of the brain on admission. (A) T1-weighted imaging revealed a hyperintense lesion in the left vertebral artery (VA; arrowhead). (B) Intracranial magnetic resonance angiography revealed that the left distal VA was occluded and there was a high intensity lesion in the VA, which indicated intramural hematoma (arrow). (C) Basiparallel anatomic scanning magnetic resonance imaging revealed focal dilatation of the left distal VA (double arrow). Journal of Stroke and Cerebrovascular Diseases 2012 21, 916.e7-916.e9DOI: (10.1016/j.jstrokecerebrovasdis.2012.04.003) Copyright © 2012 National Stroke Association Terms and Conditions

Figure 2 Digital subtraction angiography of the right vertebral artery (VA). (A) There was no abnormality in the right VA in a neutral neck position. (B) When the head was turned 60° to the left, focal stenosis appeared in the right VA at the C2 vertebral level (arrow). (C) The right VA was completely occluded when he turned his neck to the end of his range of motion. Journal of Stroke and Cerebrovascular Diseases 2012 21, 916.e7-916.e9DOI: (10.1016/j.jstrokecerebrovasdis.2012.04.003) Copyright © 2012 National Stroke Association Terms and Conditions