Abstract
We report a 30-year-old man with right midbrain infarction due to right vertebral artery fenestration. He had no anamnesis and no abnormal family history. One day, he drank an excessive amount of alcohol. The next day, he had a headache, numbness in the left half of his body, and weakness of the left leg. Neurological examination revealed left hemiparesis and dysesthesia in the left half of his body. Diffusion-weighted magnetic resonance imaging (MRI) revealed right ventral midbrain infarction. There was no abnormality in MR angiography (MRA). We excluded angiitis, coagulation abnormality, cardiogenic embolism and paradoxical embolism. On cerebral angiograms, fenestration of the right vertebral artery was shown. Therefore, we diagnosed him with right midbrain infarction due to right vertebral artery fenestration.
The connection between fenestration and aneurysm has been demonstrated; however, there are limited case reports of cerebral infarction due to fenestration. It is important to perform cerebral angiography in the case of cryptogenic cerebral infarction.
