Vertebral arterial dissection associated with Klippel-Feil syndrome in a child

BACKGROUND

Vertebral artery dissection resulting in stroke is rare in children. We report here on a 7-year-old boy with Klippel-Feil abnormality, who presented with a pontine infarction after a supervised swimming session.

METHODS

Evaluation after a second acute neurological event included a formal cerebral angiogram, which revealed a complete upper basilar artery occlusion and right vertebral arterial dissection. Cervical spine radiographs demonstrated an associated fusion of the C2 and C3 vertebrae. Anticoagulation therapy was initiated, and the neurological deficits associated with the pontine infarction resolved. Anticoagulation was discontinued after 6 months of therapy, with no recurrence of symptoms.

CONCLUSION

Vertebral artery dissection may rarely be associated with Klippel-Feil abnormality in children.

Venous malformation mimicking a posterior fossa tumor in a young child

Symptomatic venous malformations are uncommon at any age. They are extremely rare in the first decade of life. We describe a 3.5-year-old child with a cerebellar venous malformation presenting with a subacute course mimicking the more common posterior fossa tumors. The child's symptoms were due to a posterior fossa hemorrhage; she subsequently did well. The clinical, CT, angiographic, and pathologic features are described. Venous malformations should be included in the differential diagnosis of young children with evidence of posterior fossa disease.