Rare Case of Bilateral Vertebral Artery Stenosis Caused by C4-5 Spondylotic Changes Manifesting with Bilateral Bow Hunter's Syndrome

Bony obstruction of the vertebral artery on head rotation tends to occur at levels C4 and below, affecting the ipsilateral side. In this rare case, symptomatic bilateral vertebral artery stenosis occurred as a result of bony compression and was symptomatic on head rotation both to the right and to the left. This stenosis was improved with anterior decompression bilaterally, and no further events occurred postoperatively.