title: Bilateral mechanical rotational vertebral artery occlusion.
abstract: Rotational vertebral artery occlusion, or bow hunter's stroke, is reversible, positional symptomatic vertebrobasilar ischemia. The typical mechanism of action is obstruction of a dominant vertebral artery with contralateral head rotation in the setting of baseline ipsilateral vertebral artery stenosis or occlusion. Here we present a rare case of mechanical occlusion of bilateral patent vertebral arteries manifesting as near syncope with rightward head rotation. Diagnostic cerebral angiography showed dynamic right C5 vertebral occlusion and left C2 vertebral occlusion. The patient underwent right C4/5 transverse process decompression. Postoperative angiogram showed patent flow through the right vertebral artery in neutral position and with head turn with resultant resolution of symptoms.
authors: Division of Vascular Surgery, Oregon Health and Science University, Portland, Ore.
authors: Phong T
authors: PT
authors: Dargon
authors: Conrad W
authors: CW
authors: Liang
authors: Anmol
authors: A
authors: Kohal
authors: Aclan
authors: A
authors: Dogan
authors: Stanley L
authors: SL
authors: Barnwell
authors: Gregory J
authors: GJ
authors: Landry
mesh_terms: D002533:Cerebral Angiography; D002574:Cervical Vertebrae / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods; D019416:Head Movements; D006801:Humans; D008297:Male; D008875:Middle Aged; D012399:Rotation; D013575:Syncope / Q000209:etiology; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014715:Vertebrobasilar Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery