The patient, a 33-year-old male, was admitted to the hospital with “headache and dizziness with nausea and vomiting for 4 days”. The patient had a brief dizziness on 2015-01-29 due to neck and shoulder stiffness and discomfort massage, while turning his neck. On the following morning, he had a sudden onset of dizziness, nausea and vomiting with left posterior occipital headache while washing up. The local hospital showed acute cerebral infarction in the left cerebellar hemisphere by cranial MR. He had a history of smoking for 15 years and denied hypertension, type 2 diabetes mellitus and hyperlipidemia. Physical examination: T36.5℃, P 72 times/min, R 18 times/min, Bp 120/70mmHg, clear, dizziness significantly increased when turning the neck, no positive neurological signs. The blood, urine and stool were normal, glycosylated hemoglobin, tumor markers, sedimentation, rheumatology, immune panel 5, anti-neutrophil antibodies, anti-cardiolipin antibodies, anti-ENA antibodies, homocysteine and transfusion screening were normal. Ultrasound of the carotid arteries showed no significant abnormalities in the bilateral carotid arteries. The internal diameter of the right vertebral artery was uniformly thin. Bilateral vertebral artery flow velocity was within the normal range with increased RI. Head rotation has a greater effect on bilateral vertebral artery blood flow. CTA of the head and neck: sclerosis of the V3 segment of the vertebral arteries bilaterally with moderate luminal stenosis. The patient’s dizziness worsened when turning the head bilaterally. Whole-brain angiography: irregular narrowing of the lumen of the V3 segment of the vertebral arteries bilaterally, with localized aneurysmal dilatation and partial infiltration of contrast into the vascular entrapment, considered as bilateral vertebral artery entrapment.