Bow hunter syndrome due to severe stenosis of the left subclavian artery with a thoracic aortic aneurysm

Bow hunter syndrome is a rare condition characterized by repetitive syncope, which is reflected in brain stem ischaemia due to vertebral compression induced by head rotation. We herein report a rare presentation of bow hunter syndrome due to severe stenosis of the left subclavian artery with a thoracic aortic aneurysm. Disease, hypoplasia of the vertebral artery, or degenerative bone disease as well as congenital foraminal narrowing can be causative. However, to our knowledge, this is the first report describing bow hunter syndrome due to severe stenosis of the left subclavian artery. Computed tomography angiography performed with the symptom induced by head rotation demonstrated obstruction of vertebral arteries. The patient underwent successful open-chest surgery and subclavian artery construction, and postural dizziness was resolved. This report may be helpful when treating similar cases.