Bilateral vertebral arteries originate from the ipsilateral occipital arteries.

Bilateral vertebral arteries originate from the ipsilateral occipital arteries.

We report a case of a 69-year-old female patient with bilateral vertebral arteries (VAs) originate from the ipsilateral occipital arteries./r/nThe patient presented to our hospital with chest discomfort and shortness of breath. Computed tomography angiography (CTA) revealed an atypical VA course, where the V1 and V2 segments of both VAs were absent. As a result, the bilateral V3 segments of the VAs originated from the ipsilateral occipital artery. Additionally, there was aplasia of the transverse foramina of the cervical vertebra, absence of transverse foramina at C2 and C3, and aplasia at C1 (left side), C4 and C5./r/nThis represents the first documented case of bilateral vertebral arteries arising from the ipsilateral occipital artery. The surgical implications and embryological basis of this case are also discussed.