Abstract
BACKGROUND: Vertebral artery stenosis (VAS) and vertebral aneurysms are serious conditions that can be life-threatening and have a poor prognosis. The co-occurrence of VAS and a vertebral aneurysm is less common and more difficult to treat. OBSERVATIONS: The authors report the case of a patient who presented with a rare occurrence of VAS combined with a vertebral aneurysm. The optimal treatment for both VAS and the vertebral aneurysm is intravascular therapy. Since the guidewire was unable to establish an effective channel, vertebral endarterectomy was performed in combination with endovascular treatment. LESSONS: A combination of vertebral endarterectomy and endovascular treatment can effectively manage the co-occurrence of VAS and a vertebral aneurysm. https://thejns.org/doi/10.3171/CASE2475.