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Rotational carotid insufficiency: an unusual cause of bow hunter's syndrome.

Peter KanAditya SrivatsanJeremiah N JohnnsonStephen R Chen
Published in: BMJ case reports (2018)
We report an unusual case in which physiologic neck rotation impeded perfusion through the internal carotid artery. The patient had a history of prior radical neck surgery and radiation for malignancy. He presented withbow hunter's-like symptoms with transient loss of consciousness and right-sided weakness with left lateral neck rotation. A self-expanding peripheral stent was successfully used to treat the patient by preventing rotatory carotid compression. In select patients with prior neck surgery and radiation, carotid injections should be part of a dynamic cerebral angiogram if the vertebral arteries are unremarkable.
Keyphrases
  • minimally invasive
  • internal carotid artery
  • case report
  • coronary artery bypass
  • magnetic resonance imaging
  • radiation therapy
  • body composition
  • atrial fibrillation