{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:03:04Z","timestamp":1787025784481,"version":"build-2736575974"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"24","license":[{"start":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T00:00:00Z","timestamp":1670803200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,12]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Bow hunter\u2019s syndrome (BHS) is a rare condition characterized by mechanical impingement of a vertebral artery (VA) during neck rotation followed by vertebrobasilar insufficiency. Posterior fusion is a typical surgical method for BHS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The case of a 70-year-old Japanese man who presented with presyncope that occurred during right cervical rotation is reported. Given the possibility of vertebrobasilar insufficiency, digital subtraction angiography and computed tomography angiography were performed and showed a hypoplastic right VA and severe stenosis of the left VA over the occiput (O)\u2013C2 level. The blood flow of the left VA was interrupted by right cervical rotation, with resumption of blood flow on left cervical rotation. BHS was diagnosed, and posterior fusion at the O\u2013C2 level was performed. Immediately after implant fixation, selective arteriography confirmed disruption of blood flow in the left VA. The rods were removed immediately; resumption of blood flow was confirmed; and the rods were refixed, anatomically bent with slight left cervical rotation. Then, sustained blood flow in the left VA was confirmed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Posterior fixation for BHS can induce VA occlusion due to minor changes in cervical spine alignment. Intraoperative selective arteriography is a necessary tool to identify occlusion of the affected VA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case22428","type":"journal-article","created":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T02:56:01Z","timestamp":1670813761000},"source":"Crossref","is-referenced-by-count":1,"title":["Bow hunter\u2019s syndrome: temporary obstruction of blood flow in the affected vertebral artery during posterior occipitocervical fusion. Illustrative case"],"prefix":"10.3171","volume":"4","author":[{"given":"Takeru","family":"Yokota","sequence":"first","affiliation":[{"name":"Departments of Orthopaedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Otani","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Handa","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Nikaido","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Kojima","sequence":"additional","affiliation":[{"name":"Neurosurgery, Fukushima Medical University School of Medicine, Fukushima City, Fukushima Prefecture, Japan; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Masu Memorial Hospital, Nihonmatsu City, Fukushima Prefecture, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichi","family":"Konno","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1227\/00006123-197805000-00013","article-title":"Bow hunter\u2019s stroke","volume":"2","author":"Sorensen BF","year":"1978","unstructured":"Sorensen BF. 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