The current study reports a case of a 56-year-old gentleman who presented in our institute with a 3-day history of fever, respiratory distress and acute paraplegia. He is also a known case of uncontrolled type 2 diabetes mellitus, chronic liver disease and chronic obstructive airway disease. Patient was evaluated further and found to have invasive mucormycosis with venous embolism in the paravertebral venous plexus causing vertebral and cord infarction.

Vertebral arteries are usually paired major arteries of the neck. Typically, they originate from the subclavian arteries coursing superiorly along each side of neck, merging within the skull to form basilar arteries. Different variant anatomy including assymetry, complete or partial duplication, fenestration and variable origin have been explained in the literature. We have a case report of 54 year old gentle man who presented with acute headache and vomitting in our institute. CT angiogram revealed left posterior cerebral artery aneurysm causing subarachnoid hemorrhage. DSA further revealed bilateral vertebral arteries arising from the common carotid artery and left PCA aneurysm.