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


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.


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


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Conflicts of interest



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© 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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