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Yet, cases of fenestration being misdiagnosed as cerebral artery dissection have never been reported.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>We present a patient of 66-year-old female with acute onset of dizziness after chiropractic manipulation of the neck. Neck computed tomography angiography (CTA) showed \u2018double lumen\u2019 sign and \u2018intimal flap\u2019 of the V1 segment of the vertebral artery, which led to the initial diagnosis of vertebral artery dissection (VAD). However, vertebral artery fenestration at V1 segment was eventually identified by multi-directional digital subtraction angiography (DSA). Interestingly, concomitant vertebral fenestration at V3 segment, basilar fenestration and basilar artery tip aneurysm was also revealed by DSA.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The triple fenestration at vertebrobasilar artery with basilar tip artery aneurysm is extremely rare, and the fenestration at the V1 segment of vertebral artery was easily misdiagnosed as VAD due to the similar imaging morphology.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12883-020-01642-2","type":"journal-article","created":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T13:03:35Z","timestamp":1582203815000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A case of multiple Vertebrobasilar artery fenestration misdiagnosed as vertebral artery dissection"],"prefix":"10.1186","volume":"20","author":[{"given":"Feng","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaokai","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohua","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huifeng","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7722-6986","authenticated-orcid":false,"given":"Zhiyong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,2,20]]},"reference":[{"key":"1642_CR1","doi-asserted-by":"publisher","first-page":"261","DOI":"10.15274\/INR-2014-10027","volume":"20","author":"DL Cooke","year":"2014","unstructured":"Cooke DL, Stout CE, Kim WT, Kansagra AP, Yu JP, Gu A, et al. 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