A twenty-four-year-old woman with Takayasu's disease was admitted in June 1992 to the hospital because of amaurosis fugax. There were neither a history of stroke nor other neurologic signs. For a long time the patient had suffered from extreme fatigue and claudication of the upper limbs. In 1988 arteriography revealed total occlusion of both subclavian arteries and a severe filiform stenosis of the left common carotid artery. The disease appeared to be stable between 1988 and 1992 without obvious signs of inflammation. At present arteriography additionally reveals total occlusion of both common carotid arteries and the left vertebral artery. Only the right vertebral artery is patent, although presenting clear stenosis at its origin. A computed tomographic scan of the brain appears normal. The progression of the disease in the absence of inflammatory episodes since 1988 and the total dependence of the cerebral arterial circulation on the right vertebral artery are the hallmarks of this very rare case of Takayasu's disease.