猎人弓综合征1例并文献复习OA

Objective Bow hunter's syndrome(BHS),also known as rotational vertebral artery occlusion syndrome,is a rare clinical syndrome caused by mechanical compression or occlusion of the vertebral artery during head and neck rotation or extension.The most common clinical symptoms are dizziness and syncope.Its clinical manifestations are similar to those of cervical spondylosis,and it is prone to misdiagnosis in clinical practice.This paper reports a case of BHS complicated by vertebral artery intramural hematoma admitted to the Department of Neurology of The Third People's Hospital of Hubei Province and reviews the relevant literature,in the hope of improving clinicians' understanding of BHS and reducing misdiagnosis and missed diagnosis through analysis of the clinical manifestations and imaging features of this case.Method The clinical data of one patient with BHS were retrospectively analyzed,and the clinical characteristics,diagnosis,and treatment of BHS were reviewed in combination with the literature.Result The patient was a 68-year-old woman with paroxysmal loss of consciousness,which occurred mainly during neck rotation.After relevant auxiliary examinations were completed,she was diagnosed with BHS complicated with vertebral artery intramural hematoma,and was given anticoagulation and conservative treatment.At the 6-month follow-up after discharge,the vertebral artery intramural hematoma had disappeared,and no further episodes of loss of consciousness occurred.Conclusion BHS complicated by vertebral artery intramural hematoma is rare and easily overlooked.BHS should be differentiated from vertebral artery-type cervical spondylosis and other diseases.When the corresponding clinical manifestations of BHS appear,dynamic cervical vascular ultrasonography,dynamic cranial and cervical CTA,and dynamic DSA should be performed to further clarify the diagnosis and provide corresponding treatment,thereby reducing misdiagnosis and missed diagnosis.