The Vertebral Artery (VA) is classically described as originating as the first branch of the ipsilateral subclavian artery. The VA origin is variable and has been identified at the aortic arch, Common Carotid Artery (CCA), and Internal Carotid Artery. The VA arising from the carotid artery is an extremely uncommon variant. Left VA origin from the left CCA has been reported only thrice. These rare anomalous origins of the VA usually are asymptomatic. We describe symptomatic aberrant origin of left vertebral artery from left common carotid artery, a rare case.

Electrocardiographic (ECG) changes due to subarachnoid haemorrhage (SAH) are seen frequently and mimic acute myocardial infarction. For appropriate therapeutic management it is very important to distinguish acute coronary syndrome from neurogenic myocardial injury, which is a reversible condition. A 35 year old male presented to us with history of acute chest pain, ECG suggestive of anterolateral myocardial infarction for which he underwent anticoagulant therapy. It was subsequently diagnosed to be a case of SAH due to ruptured anterior communicating artery aneurysm.