From 1985 to 1989, 923 patients with cervical syndrome were treated; and among them, 69 complained chiefly of vertigo, somewhat like Barre-Lieou syndrome. Out of their X-ray films, those of the 69 patients showed foramen arcuale on the posterior arch of atlas, an incidence of 7.4%; and so it was, unilateral or bilateral, proved by operative findings. The foramen arcuale, being either a complete ring or a incomplete ring, restricted or compressed the vertebral artery passing through. Excision of the foramen arcuale and sympathectomy done on this artery released the vessel and freed the patient from symptoms up to time of the writing. Diagnostic criteria are tabulated, operative procedures described and related matters discussed in the paper. It is emphasized that the foramen arcuale must be excised completely and sympathectomy should be performed on the vertebral artery under view for cure.