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Introduction:Recurrent dissections have been described in patients with connective-tissue disorders. Recurrence risk is highest in the first months, persists for at least 10 years, and involves different arteries. The aim of this report was to present two patients with spontaneous bilateral vertebral artery (VA) dissection.             Patient1: A 10-month-old boy presented with irritability, vomiting, and torticollis with left hemiparesis. MRI (4th day) revealed ischemic infarcts incerebellar hemispheres and thalamus. MRA showed disappearance of flow signal inthe right VA from its origin. Diagnosis: Vertebral dissection. The baby was put on anticoagulant agents. MRA (at 6 months) demonstrated no recanalization ofthe right VA and filiform stenosis of the left. A digital angiography showed bilateralVA occlusion. Final diagnosis: Spontaneous recurrent bilateral VA dissection.                              Patient 2: A six-year-old boy presented with acute occipital headache, gait ataxia, and strabismus. MRI revealed ischemic lesions in cerebellar hemispheres and thalamus. MRA demonstrated no blood flow signal ofthe left VA. Second event: two months later, the boy had acute headache,vomiting, and gait ataxia. MRI showed new ischemic strokes. A digital angiography confirmed bilateral VA dissection with pseudoaneurism andintramural thrombus at the left V4 segment. He was put on anticoagulant agents.                                                                                                Common connective-tissue disorders were ruled out in both patients. Other major arteries were studied and were normal.                                                           Conclusion:We believe that underlying structural arterial-wall pathology may be a risk factor for spontaneous recurrent dissection in these patients.

Vertebral artery; recurrent dissection; ischemic stroke