Vertebral Artery Stenosis Caused by Cervical Osteophyte: A Rare and Reversible Cause of Vertebrobasilar Insufficiency. Case Report

Abstract

Bow Hunter syndrome manifests when the vertebral artery is compressed following head rotation. Symptomatic compression with vertebral artery stenosis due to cervical osteophytes is a rare cause and occurs due to a progressive degenerative process. In most cases, compression originates anteromedially from the uncinate process and is asymptomatic due to the competence of the contralateral vertebral artery. In the described patient, compression presented superomedially due to osteophytes in the superior articular facet of the C5 vertebra, and the contralateral vertebral artery was obstructed. Careful evaluation with imaging, mainly preoperative 3D angiotomography, is necessary to determine the most beneficial approach for decompression. The treatment of choice for symptomatic compression induced by cervical spondylosis is decompression surgery.

Resumo

A síndrome de Bow Hunter se manifesta quando a artéria vertebral é comprimida após a rotação da cabeça. A compressão sintomática com estenose da artéria vertebral devido a osteófitos cervicais é uma causa rara e ocorre devido a um processo degenerativo progressivo. Geralmente, a compressão se origina anteromedialmente do processo uncinado e é assintomática devido à competência da artéria vertebral contralateral. No paciente descrito, a compressão se apresentou superomedialmente devido a osteófitos na faceta articular superior da vértebra C5, e a artéria vertebral contralateral estava obstruída. Uma avaliação cuidadosa com imagens, principalmente angiotomografia 3D pré-operatória, é necessária para determinar a abordagem mais benéfica para a descompressão. O tratamento de escolha para compressão sintomática induzida por espondilose cervical é a cirurgia de descompressão.

Keywords

vertebral artery - vertebrobasilar insufficiency - osteophyte - Bow Hunter's Syndrome

Palavras-chave

artéria vertebral - insuficiência vertebrobasilar - osteófito - Síndrome de Bow Hunter

Publikationsverlauf

Eingereicht: 07. April 2024

Angenommen: 18. Oktober 2024

Artikel online veröffentlicht:
11. Dezember 2024

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