{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T22:40:36Z","timestamp":1792363236355,"version":"4.4.0"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T00:00:00Z","timestamp":1635206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009158","name":"Kawasaki Medical School","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009158","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Bow hunter's syndrome (BHS) is most commonly caused by compression of the vertebral artery (VA). It has not been known to occur due to an extracranially originated posterior inferior cerebellar artery (PICA), the first case of which we present herein. A 71-year-old man presented with reproducible dizziness on leftward head rotation, indicative of BHS. On radiographic examination, the bilateral VAs merged into the basilar artery, and the left VA was predominant. The right PICA originated extracranially from the right VA at the atlas\u2013axis level and ran vertically into the spinal canal. During the head rotation that induced dizziness, the right PICA was occluded, and a VA stenosis was revealed. Occlusion of the PICA was considered to be the primary cause of the dizziness. The patient underwent surgery to decompress the right PICA and VA <jats:italic>via<\/jats:italic> a posterior cervical approach. Following surgery, the patient's dizziness disappeared, and the stenotic change at the right VA and PICA improved. The PICA could be a causative artery for BHS when it originates extracranially at the atlas\u2013axis level, and posterior decompression is an effective way to treat it.<\/jats:p>","DOI":"10.3389\/fneur.2021.756838","type":"journal-article","created":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T05:07:06Z","timestamp":1635224826000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Case Report: Bow Hunter's Syndrome Caused by Compression of Extracranially Originated Posterior Inferior Cerebellar Artery"],"prefix":"10.3389","volume":"12","author":[{"given":"Noriya","family":"Enomoto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Yagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunji","family":"Matsubara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Uno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"E7","DOI":"10.3171\/2015.1.FOCUS14791","article-title":"Bow hunter's syndrome revisited: 2 new cases and literature review of 124 cases","volume":"38","author":"Jost","year":"2015","journal-title":"Neurosurg Focus."},{"key":"B2","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1016\/j.wneu.2014.02.027","article-title":"Diagnosis and management of bow hunter's syndrome: 15-year experience at barrow neurological institute","volume":"82","author":"Zaidi","year":"2014","journal-title":"World Neurosurg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1016\/j.wneu.2017.12.167","article-title":"Bow Hunter's syndrome by nondominant vertebral artery compression: a case report, literature review, and significance of downbeat nystagmus as the diagnostic clue","volume":"111","author":"Iida","year":"2018","journal-title":"World Neurosurg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1007\/BF00327604","article-title":"Anomalous atlantoaxial portions of vertebral and posterior inferior cerebellar arteries","volume":"27","author":"Tokuda","year":"1985","journal-title":"Neuroradiology."},{"key":"B5","doi-asserted-by":"publisher","first-page":"645","DOI":"10.3171\/jns.1999.91.4.0645","article-title":"Microsurgical anatomy of the extracranial-extradural origin of the posterior inferior cerebellar artery","volume":"91","author":"Fine","year":"1999","journal-title":"J Neurosurg."},{"key":"B6","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/s00234-011-0849-z","article-title":"Vertebral artery variations at the C1-2 level diagnosed by magnetic resonance angiography","volume":"54","author":"Uchino","year":"2012","journal-title":"Neuroradiology."},{"key":"B7","doi-asserted-by":"publisher","first-page":"E1053","DOI":"10.1097\/BRS.0000000000000447","article-title":"Vertebral artery anomalies at the craniovertebral junction in the US population","volume":"39","author":"O'Donnell","year":"2014","journal-title":"Spine."},{"key":"B8","doi-asserted-by":"publisher","first-page":"9","DOI":"10.2176\/nmccrj.2014-0075","article-title":"Bow Hunter's stroke due to stretching of the vertebral artery fenestration: a case report","volume":"2","author":"Yamaguchi","year":"2015","journal-title":"NMC Case Rep J."},{"key":"B9","doi-asserted-by":"publisher","first-page":"199","DOI":"10.3171\/2016.7.SPINE163","article-title":"Rotational vertebrobasilar insufficiency due to compression of a persistent first intersegmental vertebral artery variant: case report","volume":"26","author":"Buch","year":"2017","journal-title":"J Neurosurg Spine."},{"key":"B10","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1212\/WNL.0000000000006009","article-title":"Pearls & Oy-sters: bow hunter syndrome: a rare cause of posterior circulation stroke: do not look the other way","volume":"91","author":"Jadeja","year":"2018","journal-title":"Neurology."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.756838\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T05:07:08Z","timestamp":1635224828000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.756838\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,26]]},"references-count":10,"alternative-id":["10.3389\/fneur.2021.756838"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2021.756838","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,26]]},"article-number":"756838"}}