{"id":"1760dab9-db33-4630-81a8-4e0b23afb7ec","slug":"rotational-bow-hunters-ischemic-stroke-caused-by-post-traumatic-os-odontoideum-in-an-older-patient-an-illustrative-case","title":"Rotational Bow Hunter’s ischemic stroke caused by post-traumatic os odontoideum in an older patient: An illustrative case","authors":["Daigo Aso","Hisaaki Uchikado","Takehiro Makizono","Tomoya Miyagi","Nobuhiro Hata"],"abstract":"Background: Bow Hunter’s syndrome (BHS) is a rare condition in which head rotation or extension temporarily compresses the vertebral artery (VA), reducing blood flow to the posterior circulation. Here, a 66-year-old male developed BHS when left neck rotation caused VA compression due to a congenital os odontoideum. Case Description: A 66-year-old male presented with loss of consciousness following hyperextension/left neck rotation. Imaging revealed a chronic odontoid fracture (Anderson Type II or here likely congenital os odontoideum) with tortuosity of the right VA in the V3 segment. Notably, a posteriorly dislocated odontoid fragment caused occlusion of the dominant right VA at the ponticulus posticus, thus causing BHS. Following C1–C2 fusion, the patient’s symptoms resolved. An: A66-year-old male who sustained cervical hyperextension/left rotation at the C1–C2 level developed occlusion of the right VA and BHS due to an os odontoideum.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/1760dab9-db33-4630-81a8-4e0b23afb7ec/featured/hero-1781558758115.png","publishDate":"2025-04-04T00:00:00.000Z","doi":"10.25259/SNI_222_2025","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/1760dab9-db33-4630-81a8-4e0b23afb7ec/pdf"}