Dear Editor, Extracranial vertebral aneurysms (EVAAs) are rarely encountered and are an uncommon clinical disease. Furthermore, 1 % of the reported cases are attributed to vertebral artery (VA) disease caused by head and neck penetrating trauma.1 Other rare causes reported as inducements include blunt trauma, atherosclerosis, syphilis, rheumatoid arthritis, neurofibromatosis, various collagen vascular diseases, and spinal fractures.2 Moreover, aneurysmal lesions with relatively small volumes are found mainly by chance. However, large EVAAs may show neurological symptoms and signs corresponding to their size and location. There are also reports of cerebral blood events caused by the thrombus shedding of extracranial aneurysms, such as cerebral infarction, aneurysm thrombosis, and rupture.3 Dear Editor, Extracranial vertebral aneurysms (EVAAs) are rarely encountered and are an uncommon clinical disease. Furthermore, 1 % of the reported cases are attributed to vertebral artery (VA) disease caused by head and neck penetrating trauma.1 Other rare causes reported as inducements include blunt trauma, atherosclerosis, syphilis, rheumatoid arthritis, neurofibromatosis, various collagen vascular diseases, and spinal fractures.2 Moreover, aneurysmal lesions with relatively small volumes are found mainly by chance. However, large EVAAs may show neurological symptoms and signs corresponding to their size and location. There are also reports of cerebral blood events caused by the thrombus shedding of extracranial aneurysms, such as cerebral infarction, aneurysm thrombosis, and rupture.