The case of a 50-year-old patient who was received in the neurology department because of repetitive transient alter, left hemifacial, palsies and right hemyplegic attacks is present. Risk factors for a cerebrovascular disease were arterial hypertension and smoking. Transient attacks occurred two times before last hospital treatment. In that period (2006–2008) an EMG, CT and MR of the brain and spinal cervical cord and even a cervical myelography has been done with normal results, except cervical degenerative spondylotic changes. Routine color Doppler analysis of the carotid arteries was also normal according the patients age. A vertebral artery examined by Color Doppler showed that right one is lean and short. After the last similar attack at September 2008th, again the complete hospital examination occurred, this time with an MSCT angiography of the aortal arch, carotid and vertebral arteries. An unusual, atypical, common starting point of the brachio-cephalic aortic branch and left common carotid artery, together with a thin and lean, right vertebral artery has been found. Last one could be followed up to CII-CIII cervical segment. According to the above findings, authors opinion is that this atypical neck and brain vascularisation was the origin of clinical disturbances. Color Doppler findings of vertebral artery defects must be sometimes verified with, a proper radiological investigation.
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