Abstract
PURPOSE: This report discusses a rare case of a vertebral artery that runs above the articular pillars of the cervical vertebrae. METHODS: A 19-year-old male patient presented after a fall due to paroxysmal dizziness and gait abnormalities, and underwent cervical computed tomography angiography (CTA) for preoperative assessment before posterior cervical surgery. RESULTS: Through cervical CTA imaging, we unexpectedly discovered two variant vertebral arteries positioned superficial to the articular pillars of the cervical vertebrae. CONCLUSION: This rare case emphasizes the importance of vascular evaluation prior to cervical surgery. CTA imaging is necessary before patients requiring posterior cervical surgery. This unusual vertebral artery may have contributed to the patient's symptoms.