Bilateral isolated cerebral peduncle infarction is a rare stroke, previously reported only in adults. This report describes a paediatric burns patient with preceding cardiac arrest who developed subtle neurology. Imaging revealed bilateral isolated peduncle infarcts with hypoplasia of the left posterior communicating and vertebral arteries. Despite supportive care, the patient deteriorated and demised. This case highlights the vulnerability of peduncular perforators to haemodynamic instability and emphasises the need for early imaging in the detection of paediatric stroke.
Contribution: Isolated bilateral cerebral peduncle infarction is a rare form of stroke, particularly in the paediatric population, and is associated with a poor prognosis. Imaging plays an important role in the early diagnosis of this type of stroke.

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South African Journal of Radiology    |    ISSN: 1027-202X (PRINT)    |    ISSN: 2078-6778 (ONLINE)