| Title: |
Recurrent strokes in a patient with bow hunter syndrome and comorbid atrial fibrillation: A case study |
| Authors: |
Jala, Sheila; Tanaka, Kaishin; Lal, Aneeta; Nguba Mbopey, Jean Paul; Lalor, Peter; Powell, Alice |
| Source: |
Australasian Journal of Neuroscience ; volume 35, issue 2, page 44-51 ; ISSN 2208-6781 |
| Publisher Information: |
Walter de Gruyter GmbH |
| Publication Year: |
2025 |
| Description: |
Bow hunter’s syndrome (BHS) is a rare condition causing dynamic vertebral artery compression, which can result in recurrent strokes, posing unique challenges in patients with cardiovascular comorbidities like atrial fibrillation (AF). This case study describes the presentation, management and outcomes of a 75-year-old female with BHS and AF, who experienced recurrent posterior circulation strokes despite anticoagulation and antiplatelet therapy. A comprehensive stroke work-up, including advanced imaging, identified BHS as the primary cause. Despite adding aspirin to apixaban (Eliquis) and later switching to prasugrel (Efficient), the patient had another stroke, prompting vertebral artery embolisation. No further events occurred prior to the nine-month follow-up. Nurses play a crucial role throughout the patient’s journey and were instrumental in recognising BHS symptoms early, advocating for timely advanced imaging, and educating the patient on avoiding head rotation to minimise vertebral artery compression. They also monitored for complications, provided ongoing support during recovery, and contributed to improved patient outcomes through vigilant care and coordination with the multidisciplinary team. This case underscores the complexity of managing BHS in AF patients, highlighting the need for nuanced, multidisciplinary approaches and further research into the management of BHS in the context of other stroke risk factors. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.2478/ajon-2025-0013 |
| Availability: |
https://doi.org/10.2478/ajon-2025-0013; https://www.sciendo.com/pdf/10.2478/ajon-2025-0013 |
| Rights: |
http://creativecommons.org/licenses/by-nc-nd/4.0 |
| Accession Number: |
edsbas.DC9ED8E1 |
| Database: |
BASE |