Kozue Saito¹, Makito Hirano¹, Toshiaki Taoka², Hiroyuki Nakagawa², Takanori Kitauchi¹, Masanori Ikeda¹, Emi Tanizawa¹, Kimihiko Kichikawa² and Satoshi Ueno¹

¹Departments of Neurology and ²Radiology, Nara Medical University, Kashihara, Nara, Japan.  

Abstract

Bow hunter’s stroke (BHS) is a cerebrovascular disease caused by occlusion of the vertebral artery (VA) on head rotation. BHS is generally associated with hemodynamic changes, often leading to vertebrobasilar insufficiency symptoms, such as vertigo and faintness. Although artery-to-artery embolism has also been proposed as an underlying mechanism, it remains controversial. This report documents a case of BHS without hemodynamic changes. We describe a 26-year-old male patient who had VA occlusion on head rotation and repetitive infarction of thalami. He had an anomalous bypass of the VA and therefore no symptomatic hemodynamic changes. Thus, non-hemodynamic BHS should be considered in juvenile patients with vertebrobasilar stroke.