Spontaneous dissection of the vertebral artery is not a frequent occurrence in the vertebrobasilar system. The authors show a case with spontaneous dissection of the extracranial vertebral artery, which produced recurrent artery-to-artery embolism. The angiography revealed characteristic intimal flap. The antiplatelet and anticoagulant therapy was able to control ischemic attacks and the patient made a good clinical recovery. The angiogram performed two months later showed spontaneous resolution of the artery involved. This case shows the effectiveness of anticoagulation and antiplatelet therapy for the prevention of artery-to-artery embolism caused by the extracranial vertebral artery dissection.
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