This is a case-report of a 42 year-old man admitted in coma after a motor cycle accident with severe facial lesions, fracture of the sphenoid and of both petrous pyramids. He had a pontine infarct. Three months later magnetic resonance angiography was normal.

The paper calls attention to the common occurrence of cerebral infarction after cervical trauma which is likely to be due to cervical dissection. However, cerebral infarction is very rare indeed after cranio-facial trauma resulting in fracture of the base of the skull.

The authors believe that their case is the first recorded of this combination and may have resulted from an intracranial vertebro-basilar dissection.

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