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.