Bow hunter's syndrome is an interesting syndrome in that it is named after how a bow hunter's who usually turn their head significantly to shoot the bow and arrow. Bow Hunter's syndrome is a condition where the contralateral vertebral artery is stenosed, compressed, or occluded. Since the vertebral arteries supply blood to the posterior portion of the cranium, then patients are going to have issues with sight, vertigo and occasions of syncopy. When the condition is severe then when the patient turns their head toward the effected side of the neck then the patient will experience serious symptoms of syncopy and will be temporarily resolved once the patient turns their head back to a neutral position. If the condition does worsen then a patient will have what is called a Bow Hunter's Stroke, also known as an ischemic stroke.
Physicians are able to use CT angiography to see the seriousness of the vertebral artery. The patient will have to turn their heads throughout the study so that images of the vertebral artery in different positions can be viewed. Other ways to view the possibility of diagnosing Bow Hunter's syndrome could be Dopler Ultrasound and/or Cerebral Angiography.
If the patient is having compression from the vertebral bone of C1 or C2 then a surgeon can go in and perform surgery to release the compression of the artery. Many times ligaments or tendons in the neck are compressing on the artery and then measures can be taken to release the compression of the artery by those surrounding structures.
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