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Background: Bow hunter's syndrome, or occlusion of the vertebral artery with head rotation leading to ischemia and sometimes stroke, is rarely described in children. The authors review the literature and present a new case. Methods: Both OVID dating back to 1946 and PubMed records were reviewed using the terms ("Bow hunter syndrome" OR "bow hunter's") OR "rotational vertebral artery occlusion" combined with "child," and limited to English language. SCOPUS and the bibliographies of cases found in the search were used to identify additional articles. Results: Twelve articles were found describing 25 patients; there were 26 patients when combined with our case. Ages ranged from 1 to 18 years. Most (88.5%, 23/26) were male. Medical treatments included aspirin, clopidogrel, abciximab, enoxaparin, warfarin, and cervical collar. Stenting was tried in 2 cases but did not work long-term. Surgical treatments included decompression, cervical fusion, or a combination. We present a new case of a 12-year-old girl with recurrent stroke who had bilateral vascular compression only visible on provocative angiographic imaging with head turn. She was referred for cervical fusion, and abnormal ligamentous laxity was noted intraoperatively. Conclusions: Bow hunter's syndrome is a rare but important cause of stroke since many of the patients experience recurrent strokes before the diagnosis is made. Reasons for the male predominance are unclear. Provocative angiography plays a key role in diagnosis, and both medical treatment and neurosurgical intervention may prevent recurrence. [ABSTRACT FROM AUTHOR]

Objective Ventriculostomies are common procedures for patients with severe neurologic insults including trauma, aneurysmal rupture, tumor, infection or following an operation. Infection secondary to a ventriculostomy, meningitis or ventriculitis, carries a high morbidity and mortality. Insertion practices and maintenance of these interventions was evaluated. Methods A retrospective review was completed of patients receiving ventriculostomies at a single institution from October 2007 through September 2013. Basic patient demographics, methods of insertion and presence of infection were collected and analyzed. Results The mean of age of patients receiving ventriculostomies was 49 years of age and the most common indications for insertion were trauma, infection and nontraumatic intracranial hemorrhage (aneurysmal subarachnoid hemorrhage (SAH), hemorrhagic stroke, arteriovenous malformation (AVM)). External ventricular drains (EVDs) were inserted after minimal hair removal at the time of procedure, tunneling following procedure and securement of EVDs with suture at exit of skin and remainder of drain stapled to scalp without additional dressing applied. The infection rate using this practice was 5.1%. Conclusion Ventriculostomies with minimal hair removal and no dressing have equivalent infection rates with the most recent published national average. [ABSTRACT FROM AUTHOR]