Juvenile Cerebral Infarction Caused by Bow Hunter's Syndrome during Sport: Two Case Reports

Neurol Med Chir (Tokyo). 2016 Sep 15;56(9):580-3. doi: 10.2176/nmc.cr.2015-0351. Epub 2016 Apr 6.

Abstract

We report two cases of juvenile cerebral infarction caused by bow hunter's syndrome (BHS) during sport. Case 1 was a 17-year-old male who developed a partial visual field defect after playing basketball. BHS was diagnosed because cervical ultrasonography demonstrated occlusion of the vertebral artery when the neck was rotated. After C1-2 posterior fixation was performed, his symptoms resolved. Case 2 was an 18-year-old male with recurrent visual disturbance after playing handball. Cerebral infarction occurred repeatedly despite antiplatelet therapy. After 3 years, vertebral artery dissection was diagnosed and stenting was performed, but his symptoms did not resolve. BHS was diagnosed when he was examined at our department. C1-2 posterior fixation was performed and his symptoms resolved. In these two cases, BHS was caused by sporting activity. For accurate diagnosis and treatment of BHS, neuroimaging with cervical rotation is mandatory.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Athletic Injuries / diagnostic imaging*
  • Athletic Injuries / etiology
  • Athletic Injuries / surgery
  • Cerebral Infarction / diagnostic imaging*
  • Cerebral Infarction / etiology*
  • Cerebral Infarction / surgery
  • Head Movements*
  • Humans
  • Male
  • Vertebral Artery Dissection / diagnostic imaging*
  • Vertebral Artery Dissection / etiology*
  • Vertebral Artery Dissection / surgery