Symptomatic Intracranial Vertebral Artery Dissection in a Pediatric Patient with Newly Diagnosed Takayasu Arteritis and Disseminated Tuberculosis: A Case Report

Pediatric arterial ischemic strokes present a unique diagnostic challenge because of the complex work-up needed to identify an underlying pathology. We report a 17-year-old female presenting with a left lateral caudal pontine syndrome. Neuroimaging revealed a left anterior inferior cerebellar artery infarct from a symptomatic left intracranial vertebral artery dissection. Further work-up revealed Takayasu arteritis and disseminated tuberculosis. The incidence of intracranial vertebral artery dissection is not known, and there is paucity of literature documenting its occurrence in the pediatric age group, more so on the background of a large vessel vasculitis and a disseminated tuberculous infection. This case report presents and discusses a rare pathomechanism of pediatric stroke and emphasizes the importance of a complete work-up so that proper management may be instituted.