Two case presentations and surgical management of Bow Hunter's syndrome associated with bony abnormalities of the C7 vertebra Victoria Lee, BS, Thomas.

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Presentation transcript:

Two case presentations and surgical management of Bow Hunter's syndrome associated with bony abnormalities of the C7 vertebra Victoria Lee, BS, Thomas S. Riles, MD, Jennifer Stableford, MD, Ramon Berguer, MD Journal of Vascular Surgery Volume 53, Issue 5, Pages 1381-1385 (May 2011) DOI: 10.1016/j.jvs.2010.11.093 Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 1 Anatomy of the vertebral artery in relation to bony structures in the neck. (Reprinted from Cloud GC, Markus HS. Diagnosis and management of vertebral artery stenosis. QJM 2003;96:27-54, by permission of Oxford University Press.) Journal of Vascular Surgery 2011 53, 1381-1385DOI: (10.1016/j.jvs.2010.11.093) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 2 An angiogram of the left vertebral artery in symptomatic left head turn position shows evidence of short-segment near-occlusion at the level of C7. Journal of Vascular Surgery 2011 53, 1381-1385DOI: (10.1016/j.jvs.2010.11.093) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 3 A computed tomography scan of the cervical spine at the level of C7 demonstrates the presence of an accessory bony canal (arrow) within the transverse foramen. Journal of Vascular Surgery 2011 53, 1381-1385DOI: (10.1016/j.jvs.2010.11.093) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 4 An angiogram of the right vertebral artery in neutral head position shows no evidence of filling defects. Journal of Vascular Surgery 2011 53, 1381-1385DOI: (10.1016/j.jvs.2010.11.093) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 5 An angiogram of the right vertebral artery in right head turn position shows evidence of flow disruption at the level of C7. Journal of Vascular Surgery 2011 53, 1381-1385DOI: (10.1016/j.jvs.2010.11.093) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 6 A preoperative computed tomography scan of the cervical spine demonstrates a right hypertrophic transverse process of C7 with the right vertebral artery present within the transverse foramen (arrow). Journal of Vascular Surgery 2011 53, 1381-1385DOI: (10.1016/j.jvs.2010.11.093) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 7 A postoperative computed tomography scan of the cervical spine at the level of C7 demonstrates successful vertebral artery decompression (arrow) after removal of the anterior tubercle, costotransverse bar, and posterior tubercle. Journal of Vascular Surgery 2011 53, 1381-1385DOI: (10.1016/j.jvs.2010.11.093) Copyright © 2011 Society for Vascular Surgery Terms and Conditions