Artery‐to‐Artery Embolism with a Mobile Mural Thrombus Due to Rotational Vertebral Artery Occlusion

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.