What Is Bow Hunter’s Syndrome?

Medically Reviewed by Jabeen Begum, MD on November 27, 2021

Do you get dizzy, feel vertigo, or notice tingling when you turn your head or neck a certain way? You could have bow hunter’s syndrome, or rotational vertebral artery occlusion, as it’s officially known. It takes its name from the way a hunter turns their head to aim a bow and arrow.

You might also hear this condition called:

  • Cervical vertigo
  • Cervical dizziness
  • Cervicogenic vertigo
  • Cervicogenic dizziness

And while these terms are used a lot, none is an officially recognized and diagnosed condition.

What Causes It?

The most common cause is a bone spur on the vertebrae in your neck. These mostly result from wear and tear over time. When you move your head a certain way, it pinches the artery shut.

You might get symptoms if you have a narrowed artery or poorly formed blood vessel in your neck.

It’s most likely to affect men and to involve the left vertebral artery.

What Are the Symptoms?

They only happen when you turn your head. You may notice a few different things:

These symptoms can last anywhere from a few minutes to a few hours.


It can be tricky. Your doctor may be able to spot the cause with imaging tests like an ultrasound, CT scan, or MRI (magnetic resonance imaging).

But the best way is a test called digital subtraction angiography, which is a sort of X-ray of your arteries. You might hold your head normally for one test, then move it in the direction that causes the problem for a second.


It depends on the cause. If you have a vascular problem, your doctor may give you drugs to prevent blood clots, plus a cervical collar to keep your neck steady. And they'll probably tell you to try not to turn your head.

If bone spurs are to blame, you may need surgery to remove them. The doctor will call this decompression.

WebMD Medical Reference



Neurology: “Rotational vertebral artery occlusion.”

Baylor University Medical Center Proceedings: “Bowhunter's syndrome diagnosed with provocative digital subtraction cerebral angiography.”

American Physical Therapy Association: “Fact Sheet: Cervicogenic Dizziness.”

Journal of Vascular and Interventional Neurology: “Rare Etiology of Bow Hunter’s Syndrome and Systematic Review of Literature."

Mayo Clinic: “Cervical spondylosis,” “Neck pain.”

Vestibular Disorders Association: “Cervicogenic Dizziness.”

Princeton University: “Introduction to Digital Subtraction Angiography.”

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