We report a case of anastomosis between the internal carotid and verte
bral a. in the cervical region. This anatomic variation is due to inco
mplete migration during embryogenesis of the branchial aa., collateral
s of the dorsal aorta, towards the ventral aorta. It does not involve
persistence of a type I proatlantal a., as described by Lasjaunias. Su
ch anastomoses must be recognised since they may modify surgical tacti
cs in the context of endarterectomy for carotid stenosis.