Abstract
We describe a 2-year-old girl with bow hunter syndrome complicated by vertebral artery dissection and multiple ischemic infarcts. Pediatric bow hunter syndrome is a rare and likely under-recognized disorder. Interestingly, our patient had atlanto-occipital ligament calcification on CT scan, an imaging finding that has not been reported in association with bow hunter syndrome and one that might help increase recognition of this dynamic disorder of the posterior circulation.
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References
Sorensen BF (1978) Bow hunter's stroke. Neurosurgery 2:259–261
Greiner HM, Abruzzo TA, Kabbouche M et al (2010) Rotational vertebral artery occlusion in a child with multiple strokes: a case-based update. Childs Nerv Syst 26:1669–1674
Zaidi HA, Albuquerque FC, Chowdhry SA et al (2014) Diagnosis and management of bow hunter's syndrome: 15-year experience at Barrow Neurological Institute. World Neurosurg 82:733–738
Rollins N, Braga B, Hogge A et al (2017) Dynamic arterial compression in pediatric vertebral arterial dissection. Stroke 48:1070–1073
Anene-Maidoh TI, Vega RA, Fautheree GL et al (2013) An unusual case of pediatric bow hunter's stroke. Surg Neurol Int 4:148
Missori P, Marruzzo D, Peschillo S et al (2014) Clinical remarks on acute post-traumatic atlanto-axial rotatory subluxation in pediatric-aged patients. World Neurosurg 82:e645–e658
Kuether TA, Nesbit GM, Clark WM, Barnwell SL (1997) Rotational vertebral artery occlusion: a mechanism of vertebrobasilar insufficiency. Neurosurgery 41:427–432
Ferreiro DM, Fullerton HJ, Bernard TJ et al (2019) Management of stroke in neonates and children: a scientific statement from the American Heart Association/American Stroke Association. Stroke 50:e51–e96
Agrawal N, Johnston SC, Wu YW (2009) Imaging data reveal a higher pediatric stroke incidence than prior US estimates. Stroke 40:3415–3421
Ahn J, Duran M, Syldort S et al (2018) Arcuate foramen: anatomy, embryology, nomenclature, pathology, and surgical considerations. World Neurosurg 118:197–202
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Cohen, N.T., Harrar, D.B., Diab, Y.A. et al. Atlanto-occipital ligament calcification: a novel imaging finding in pediatric rotational vertebral artery occlusion. Pediatr Radiol 50, 137–141 (2020). https://doi.org/10.1007/s00247-019-04515-0
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DOI: https://doi.org/10.1007/s00247-019-04515-0