{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T23:06:07Z","timestamp":1785884767977,"version":"3.56.0"},"reference-count":12,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nThe authors present a previously unreported case of a patient with diffuse idiopathic skeletal hyperostosis (DISH) who developed bow hunter\u2019s syndrome (BHS) or positional vertebrobasilar insufficiency. In addition, the authors demonstrate angiographic evidence of remote osseous remodeling after segmental fusion without direct decompression of the offending bony growth. BHS is a rare, yet well established, cause of posterior circulation ischemia and ischemic stroke. Several etiologies such as segmental instability and spondylosis have been described as causes, however, DISH has not been associated with BHS before this publication.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nA 77-year-old man who presented with BHS was found to have cervical spine changes consistent with DISH, and angiography confirmed right vertebral artery (VA) stenosis at C4\u20135 from a large pathological elongation of the right C5 lateral mass. Head rotation resulted in occlusion of the VA. The patient underwent an anterior cervical discectomy and fusion and reported complete resolution of his symptoms. A delayed angiogram and CT of the cervical spine demonstrated complete resolution of the baseline stenosis, no dynamic compression, and remote osseous remodeling of the growth, respectively.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nThis case represents the first publication in the literature of DISH as a causative etiology of BHS and of angiographic data demonstrating resolution of a compressive osseous pathology without direct decompression in BHS.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_762_2020","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T19:44:34Z","timestamp":1615923874000},"page":"104","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Fusion for subaxial bow hunter\u2019s syndrome results in remote osseous remodeling of the hyperostotic growth responsible for vertebral artery compression"],"prefix":"10.25259","volume":"12","author":[{"given":"Daniel Satoshi","family":"Ikeda","sequence":"first","affiliation":[{"name":"Department of Surgery, US Naval Hospital Okinawa, Okinawa, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles A.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, Maryland, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay M.","family":"Ravindra","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Naval Medical Center San Diego, San Diego, California, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2021,3,17]]},"reference":[{"key":"10.25259\/SNI_762_2020\/ref-1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.14444\/4017","article-title":"Regression of disc-osteophyte 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