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Updated: Jun 27, 2026

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Artery-to-artery embolism with a mobile mural thrombus due to rotational vertebral artery occlusion
Kozue Saito1, Makito Hirano, Toshiaki Taoka
1Department of Neurology, Nara Medical University, Nara, Japan. ksaito@naramed-u.ac.jp
Abstract:
Rotational vertebral artery (VA) occlusion can cause ischemic strokes due to hemodynamic insufficiency and possibly artery-to-artery (A-to-A) embolism. The former is known as bow hunter's stroke. The latter has been proposed only from indirect evidence. We have described a 7-year-old boy with cerebral infarction associated with A-to-A embolism due to repetitive rotational VA occlusion. He had a mobile mural thrombus at the VA occlusion site on head rotation. Surgical treatment may effectively prevent recurrences.
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