Bow hunter's syndrome is characterized by transient vertebrobasilar 
insufficiency that is elicited by neck rotation. This syndrome is has various 
causes, such as osteophytes, tumors, fibrous bands, infection, and trauma. We 
report a unique case of bow hunter's syndrome. The patient visited our hospital 
because of left nuchal pain. A magnetic resonance imaging scan revealed left 
vertebral artery (VA) dissection, which was the cause of his nuchal pain. He 
began to feel faintness upon turning his neck to the left after left VA 
dissection. Digital subtraction angiography revealed that the right VA was fully 
patent in a neutral neck position, but focal stenosis appeared at the C2 
vertebral level upon turning his head 60° to the left. This stenosis became 
complete occlusion at turning his head to the end of his range of motion. From 
these findings, a diagnosis of bow hunter's syndrome was made. Dissection of the 
contralateral (left) VA caused a failure in compensatory blood flow, resulting 
in bow hunter's syndrome. This represents the first report of bow hunter's 
syndrome occurring after onset of the contralateral VA dissection.