A 46 years old previously healthy female was brought to emergency department (ED) with alleged history of road traffic accident (RTA) while driving a car one hours back. She was initially assymptomatic for about one hours post accident but later deteriorated both hemodynamically and mentation. After aggressive resuscitation as per ATLS protocol, she underwent multiple radiological imaging studies which revealed bilateral carotid and vertebral arteries dissection and severe traumatic brain injury with bilateral peripheral infarction. She was managed conservatively with mechanical ventilation in the intensive care unit.