Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 11 2018 01 02 718 721 EN Ahmad Pour Rashidi Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Saeed Saeedinia Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Shiran Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Kourosh Karimi Yarandi Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Maysam Alimohamadi Brain and Spinal Cord Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran. 2016 05 29 2017 02 01 Bilateral occlusion of internal carotid arteries is a rare condition usually associated with severe neurological symptoms. It is very uncommon finding among patients with ischemic stroke. In this article, we report a rare case of bilateral occlusion of internal carotid artery who presented with mild reversible neurological symptoms. Angiographic evaluation of her cerebral vasculature revealed no flow across the both cervical internal carotid arteries, but a run off through both posterior communicating arteries from the vertebrobasilar system. We performed a review of the pertinent literature and discussed different management option in these patients. https://acta.tums.ac.ir/index.php/acta/article/view/5666 https://acta.tums.ac.ir/index.php/acta/article/download/5666/5012