We present 2 cases of dissection of the bilateral vertebral arteries. A 57-year-old man suffered severe occipital headache. Computed tomography (CT) scan demonstrated no evidence of intracranial bleeding. Magnetic resonance images (MRI) revealed intraluminal thrombus in the bilateral vertebral arteries, and magnetic resonance angiography (MRA) showed narrowing and dilatation of the bilateral vertebral arteries. Cerebral angiography comfirmed the diagnosis of dissection of the bilateral vertebral arteries. Because he had no neurological symptoms, no treatment was administered. Four months later, MRA demonstrated spontaneous improvement of the previous abnormal findings.
Another case was a 38-year-old woman, who suddenly lost consciousness. CT scan revealed subarachnoid hemorrhage. Cerebral angiography demonstrated “pearl and string sign” in the bilateral vertebral arteries, indicating dissecting aneurysms. She was treated conservatively, and her consciousness gradually improved. Fourteen months after onset, she was in good condition without any neurological deficits. On MRA, there has been no change in the abnormal findings of the bilateral vertebral arteries.
