Atypical case of bow hunter’s syndrome linked to aberrantly coursing vertebral artery: A case report

Figure 1 Preoperative computed tomography angiography and perfusion magnetic resonance imaging studies. A: Normal C6 vertebral artery (VA) entry on left and anomalous right VA entry at C4 transverse foramen (arrow); B: Axial view of patent right VA in neutral position (arrow); C and D: Rotational dynamic compression of right VA by thyroid cartilage and anterior tubercle of C5 transverse process (arrows); E: Time-to-peak delay in right cerebellar territory (arrow) during head rotation to right.

Figure 2 Postsurgical computed tomography angiography. A: Anterior tubercle of C5 transverse process eliminated and right vertebral artery (VA) patent (arrow); B and C: Axial and sagittal images during right rotation of head showing no dynamic VA compression (arrows).