# Bilateral and Multilevel Vertebral Artery Loop Formation Causing Cervical Radiculopathy: A Case Report and Literature Review

## TL;DR

A 60-year-old man with unusual vertebral artery loops causing neck and arm pain was successfully treated without surgery.

## Contribution

This case report adds to the understanding of multilevel vertebral artery loop formation and its management.

## Key findings

- Bilateral and multilevel vertebral artery loops were identified at C4-5 and left V1 segments.
- Conservative management resolved the patient's symptoms over six months.
- Literature review shows both conservative and surgical approaches can be effective.

## Abstract

We present a case of a 60-year-old man with bilateral and multilevel vertebral artery loop formation (VALF) presenting with chronic cervicobrachialgia and dizziness. Magnetic resonance imaging (MRI) revealed bilateral vertebral artery loops at C4-5 compressing the right C5 nerve root, with computed tomography angiography (CTA) identifying an additional loop at the left V1 segment. The patient's symptoms resolved completely with conservative management over a six-month follow-up period. A literature review comparing similar cases over the past two decades reveals successful conservative and surgical management approaches.