Causality of pediatric brainstem infarction and basilar artery fenestration?

Pediatric arterial thromboembolic stroke is an uncommon condition and rarely is reported to be associated with a cerebral artery fenestration. This clinical report discusses the case of a child with brainstem infarction and basilar artery fenestration. A cardiac source of thromboembolic events could be excluded; however, detailed coagulation analysis revealed in addition an apoliopoprotein(a) size polymorphism. Because we assume that the two concurrent pathologies in combination caused the arterial thromboembolic stroke, the evaluation of all potential triggers including vascular anomalies and coagulation disorders should be considered in unexplained pediatric infarction.