Dissected duplicated origin of left vertebral artery as a rare cause of recurrent posterior circulation stroke: a case report and literature review

Duplicated origin of the left vertebral artery (LVA) is an uncommon vascular variant that is usually asymptomatic but can predispose to dissection and embolic stroke. It is often under-recognized in standard imaging. Case Report: We present a 63-year-old male with three posterior circulation strokes. Initial CTA, MRA, and cardiac workup were unremarkable. Digital subtraction angiography (DSA) revealed a dissected duplicated origin of the LVA. The patient underwent successful endovascular flow-diverter treatment and has remained stroke-free on follow-up. This case highlights the importance of considering anatomic variants in recurrent posterior circulation strokes. DSA remains essential for diagnosis when non-invasive imaging is inconclusive. Flow-diverter embolization was safe and effective treatment for pathological duplicated LVA segment in our patient.