Dual origin of the left vertebral artery: a rare anatomic variation

Duplication of the vertebral artery is a very rare vascular variant. We describe a case of a duplicated left vertebral artery. Computed tomography (CT) angiography examination of the head and neck vessels of a 63-year-old man with a history of imbalance was undertaken. A duplicated left vertebral artery was incidentally noted. The medial limb directly originated from the arcus aorta between the left common carotid artery and the left subclavian artery. The lateral limb originated from the proximal left subclavian artery as the first branch and entered the transverse foramen of the C6 vertebra as usual. Prior to neck procedures requiring the anterior cervical approach and carotid endarterectomy, the awareness and diagnosis of the duplicated vertebral artery are important due to the potential risk of inadvertent vertebral artery injury. Therefore, this variation should be taken into account while evaluating cross-sectional imaging studies.