Rotational carotid insufficiency: An unusual cause of bow hunter's syndrome

Peter Kan, Aditya Srivatsan, Jeremiah N. Johnnson, Stephen R. Chen

Research output: Contribution to journalArticlepeer-review


We report an unusual case in which physiologic neck rotation impeded perfusion through the internal carotid artery. The patient had a history of prior radical neck surgery and radiation for malignancy. He presented withbow hunter's-like symptoms with transient loss of consciousness and right-sided weakness with left lateral neck rotation. A self-expanding peripheral stent was successfully used to treat the patient by preventing rotatory carotid compression. In select patients with prior neck surgery and radiation, carotid injections should be part of a dynamic cerebral angiogram if the vertebral arteries are unremarkable.

Original languageEnglish (US)
Article number014210
JournalBMJ Case Reports
StatePublished - 2018
Externally publishedYes


  • artery
  • blood flow
  • intervention
  • neck
  • stent

ASJC Scopus subject areas

  • General Medicine


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