A rare case of bilateral internal carotid artery and right vertebral artery occlusion

Bilateral internal carotid artery (ICA) occlusion is a rare type of cerebrovascular disease that carries a high risk for recurrent transient ischemic attacks. We report a case involving a 67-year-old man presenting with bilateral internal carotid artery (ICA) occlusion, along with an additional occlusion in the right vertebral artery. Imaging revealed adequate collateral flow through the posterior circulation and external carotid artery (ECA) collaterals. He was treated with antiplatelet therapy. During follow up, neurologic examination showed no focal deficits. While bilateral ICA occlusion can have devastating clinical outcomes, it may be a relatively benign condition if there is sufficient collateral circulation.