Bow Hunter's syndrome is an unusual symptomatic vertebrobasilar insufficiency 
resulting from intermittent mechanical compression of the vertebral artery, and 
is rarely a trigger for cerebral infarction following thrombus formation on the 
damaged endothelial vessels (Bow Hunter's stroke). The authors present an 
extremely rare case of a 45-year-old man showing Bow Hunter's stroke due to 
congenital vertebral artery fenestration stretching and sliding between C1 and 
C2 after head rotation to the right. Congenital vertebral artery anomaly rarely 
causes cerebral infarction, but could cause embolic strokes by mechanical 
stretching without bony abnormalities.