Case Report
DOI : https://doi.org/10.3340/jkns.2010.47.2.134

Journal of Korean Neurosurgical Society. 2010; 47(2): 134-136.

doi: https://doi.org/10.3340/jkns.2010.47.2.134

Bow Hunter's Stroke Caused by a Severe Facet Hypertrophy of C1-2.

Chung Kee Chough, Boyle C Cheng, William C Welch, and Chun Kun Park

¹Department of Neurosurgery, The Catholic University of Korea College of Medicine, St. Mary's Hospital, Seoul, Korea. chough@catholic.ac.kr
²Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, USA.
³Department of Neurological Surgery, University of Pennsylvania, Philadelphia, USA.
⁴Department of Neurosurgery, The Catholic University of Korea College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea.

Bow hunter's stroke is a rare symptomatic vertebrobasilar insufficiency in which vertebral artery (VA) is mechanically occluded during head rotation. Various pathologic conditions have been reported as causes of bow hunter's stroke. However, bow hunter's stroke caused by facet hypertrophy of C1-2 has not been reported. A 71-year-old woman presented with symptoms of vertebrobasilar insufficiency. Spine computed tomography showed massive facet hypertrophy on the left side of C1-2 level. A VA angiogram with her head rotated to the right revealed significant stenosis of left VA. C1-2 posterior fixation and fusion was performed to prevent serious neurologic deficit from vertebrobasilar stroke.