In clinical practice, the vertebral arteries of a patient are often found to be not equal in size and the basilar artery may not be situated in the center. Our observational study showed that vertebral dominance and basilar bending are common, and their occurrence is related to advanced age and hypertension. The right vertebral dominance tends to coincide with left basilar bending, and, vice versa, the left vertebral dominance tends to coincide with right basilar bending. The left vertebral dominance is more common than the right dominance. Vertebral dominance and basilar bending are risk factors for brainstem infarction and transient ischemic attack (TIA) and their early detection can prompt measures to be taken to prevent the onset of brain infarction and TIA.

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