Rotational vertebral artery syndrome (RVAS), or Bow Hunter syndrome, is a rare but surgically amenable cause of vertebrobasilar insufficiency due to dynamic and reversible occlusion of the dominant vertebral artery. Head and neck rotation can lead to vertebral artery compression at the atlantoaxial or subaxial levels in the spine. Patients typically have a history of transient ischemic attacks, presyncope, syncope, or severe strokes in the posterior circulation. The predominant symptoms are vertigo and cervicogenic dizziness. The most common causes are degenerative lesions of the cervical spine, notably osteophytes, fibrous bands, and lateral disc herniations. Healthcare professionals must consider all potential causes when diagnosing the underlying pathology of vertebrobasilar insufficiency. Accurate diagnosis requires a thorough understanding of vertebral artery anatomy and the use of advanced imaging techniques, particularly dynamic rotational angiography, to identify arterial compression. Treatment strategies include both conservative management, such as avoiding head rotation and using cervical collars, and medical therapies, such as antiplatelet or anticoagulation therapy. In some cases, surgical intervention may be necessary to alleviate the compression. This activity examines the underlying pathology of this rare condition and explores the role of imaging techniques and clinical assessments in confirming the diagnosis. This activity also covers current therapeutic strategies, including medical management and surgical interventions, for both acute and chronic RVAS cases. In addition, this activity provides clinicians with comprehensive knowledge and practical skills to recognize, diagnose, and manage RVAS effectively. Furthermore, this activity also highlights the role of the interprofessional healthcare team in collaborating to optimize outcomes for affected patients.
- Provider:StatPearls, LLC
- Activity Link: https://www.statpearls.com/ArticleLibrary/viewarticle/105326
- Start Date: 2023-09-01 05:00:00
- End Date: 2023-09-01 05:00:00
- Credit Details: AMA PRA Category 1 Credit™️: 1.0 hours
Nursing: 1.0 hours
Pharmacy: 1.0 hours - MOC Credit Details: ABS - 1.0 Point; Credit Type(s): Accredited CME (ABS)
ABPATH - 1.0 Point; Credit Type(s): Lifelong Learning (ABPATH)
ABIM - 1.0 Point; Credit Type(s): Medical Knowledge (ABIM)
ABS - 1.0 Point; Credit Type(s): Self-Assessment (ABS)
ABP - 1.0 Point; Credit Type(s): Lifelong Learning and Self-Assessment (ABP) - Commercial Support: No
- Activity Type: Enduring Material
- CME Finder Type: Online Learning
- Fee to Participate: Variable
- Measured Outcome: Learner Knowledge, Learner/Team Competence
- Provider Ship: Directly Provided
- Registration: Open to all
- Specialty: General Pediatrics, Internal Medicine, Neuropathology (incl. Neuromuscular), Pediatric Neurology, Vascular Surgery