Fenestration of the supraclinoid internal carotid artery associated with aneurysm and ischemic stroke

Background: Fenestration of the ICA is extremely rare, and the most common associated vascular abnormality is cerebral aneurysm. The relationship between fenestration and ischemic stroke is unknown. Case Description: We present a case of a young adult with SAH resulting from a ruptured aneurysm, associated with the bilateral fenestrated supraclinoid ICAs. This case is unusual because of a history of 2 ischemic strokes and the concomitant finding of other vascular abnormalities. Conclusion: Besides associated with aneurysm, ischemic stroke also indicates that fenestration may be a risk factor for thrombus or embolus formation.