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Atlanto-occipital ligament calcification: a novel imaging finding in pediatric rotational vertebral artery occlusion

  • Nathan T. CohenEmail author
  • Dana B. Harrar
  • Yaser A. Diab
  • Monica S. Pearl
  • Jonathan G. Murnick
Case Report

Abstract

We describe a 2-year-old girl with bow hunter syndrome complicated by vertebral artery dissection and multiple ischemic infarcts. Pediatric bow hunter syndrome is a rare and likely under-recognized disorder. Interestingly, our patient had atlanto-occipital ligament calcification on CT scan, an imaging finding that has not been reported in association with bow hunter syndrome and one that might help increase recognition of this dynamic disorder of the posterior circulation.

Keywords

Atlanto-occipital ligament Bow hunter syndrome Calcification Child Posterior circulation Stroke Vertebral artery 

Notes

Compliance with ethical standards

Conflicts of interest

None

References

  1. 1.
    Sorensen BF (1978) Bow hunter's stroke. Neurosurgery 2:259–261CrossRefGoogle Scholar
  2. 2.
    Greiner HM, Abruzzo TA, Kabbouche M et al (2010) Rotational vertebral artery occlusion in a child with multiple strokes: a case-based update. Childs Nerv Syst 26:1669–1674CrossRefGoogle Scholar
  3. 3.
    Zaidi HA, Albuquerque FC, Chowdhry SA et al (2014) Diagnosis and management of bow hunter's syndrome: 15-year experience at Barrow Neurological Institute. World Neurosurg 82:733–738CrossRefGoogle Scholar
  4. 4.
    Rollins N, Braga B, Hogge A et al (2017) Dynamic arterial compression in pediatric vertebral arterial dissection. Stroke 48:1070–1073CrossRefGoogle Scholar
  5. 5.
    Anene-Maidoh TI, Vega RA, Fautheree GL et al (2013) An unusual case of pediatric bow hunter's stroke. Surg Neurol Int 4:148CrossRefGoogle Scholar
  6. 6.
    Missori P, Marruzzo D, Peschillo S et al (2014) Clinical remarks on acute post-traumatic atlanto-axial rotatory subluxation in pediatric-aged patients. World Neurosurg 82:e645–e658CrossRefGoogle Scholar
  7. 7.
    Kuether TA, Nesbit GM, Clark WM, Barnwell SL (1997) Rotational vertebral artery occlusion: a mechanism of vertebrobasilar insufficiency. Neurosurgery 41:427–432CrossRefGoogle Scholar
  8. 8.
    Ferreiro DM, Fullerton HJ, Bernard TJ et al (2019) Management of stroke in neonates and children: a scientific statement from the American Heart Association/American Stroke Association. Stroke 50:e51–e96Google Scholar
  9. 9.
    Agrawal N, Johnston SC, Wu YW (2009) Imaging data reveal a higher pediatric stroke incidence than prior US estimates. Stroke 40:3415–3421CrossRefGoogle Scholar
  10. 10.
    Ahn J, Duran M, Syldort S et al (2018) Arcuate foramen: anatomy, embryology, nomenclature, pathology, and surgical considerations. World Neurosurg 118:197–202CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of NeurologyChildren’s National Health SystemWashingtonUSA
  2. 2.Departments of Neurology and PediatricsGeorge Washington University School of Medicine and Health SciencesWashingtonUSA
  3. 3.Division of Hematology/OncologyChildren’s National Health SystemWashingtonUSA
  4. 4.Department of PediatricsGeorge Washington University School of Medicine and Health SciencesWashingtonUSA
  5. 5.Division of Interventional Neuroradiology, Department of RadiologyThe Johns Hopkins University School of MedicineBaltimoreUSA
  6. 6.Division of Diagnostic Imaging and RadiologyChildren’s National Health SystemWashingtonUSA
  7. 7.Department of Radiology and PediatricsGeorge Washington University School of Medicine and Health SciencesWashingtonUSA

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