2026 Poster Presentations
P398: DIRECT VERTEBRAL ARTERY DECOMPRESSION FOR TREATMENT OF BOWHUNTER'S SYNDROME
Moleca Ghannam, MD1; Tina Wang, MA2; Timothy R Miller, MD2; Dheeraj Gandhi, MBBS2; Mohamed Labib, MD2; 1University at Buffalo; 2University of Maryland School of Medicine
We present a young man with Bowhunter’s syndrome manifesting as faintness and agitation triggered by rightward head rotation. Dynamic angiography revealed near-complete occlusion of the dominant left V3 segment with head turning, in the setting of a hypoplastic contralateral vertebral artery. He underwent far lateral exploration of the left V3 with release of a constricting ligamentous band and bony decompression of C1. Postoperative angiography confirmed decompression with preserved flow, and his symptoms completely resolved.