Bow Hunters Syndrome is a condition where the vertebral artery is pinched of or occluded during neck rotation. Often there are no problems while the neck is in a neutral position or turned the opposite direction.
CT angiography can be performed to aid in diagnosis though MRA might be the modality of choice.
Bow hunters syndrome may be suspected when symptoms of vertigo, dizziness, disequilibrium, hearing loss, and or ear pain occurs when turning the head and neck no matter whether laying, standing, or any other orientation to the plane of gravity. In the image you can see where the vertebral artery is being pinched as it passes through the vertebrae.
Some causes of bow hunters syndrome are, vascular compression caused by compression of the vertebral arteries by vertebrae of other structures; Lack of sensory perception; cervical cord compression, which is most common; or a cerebrospinal fluid leak caused by a tear in the cervical root sleeve.
Anterior decompression of the vertebral foramen can be performed with little or no complications as far as restriction of movement in neck.
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