THE MAJORITY of cerebrovascular accidents in children involve the carotid circulation. 1 The few that have occurred in the vertebrobasilar circulation usually involve occlusion within the basilar artery. 2 We report the sudden onset of a typical lateral medullary (Wallenberg) syndrome in a boy. Vertebral artery occlusion was shown roentgenographically. Previous reports of a Wallenberg syndrome in children have been rare and atypical. 3,4 Report of a Case An 8-year-old Navajo boy had a minor fall on the right side of his face, with no apparent injury and no loss of consciousness. On the following day, he complained of vomiting, dizziness, staggering, weakness on the left side, difficulty in swallowing, and severe headache. Positive findings on neurologic examination included lethargy, horizontal nystagmus most marked on left gaze, hypalgesia on the left side of the face, absent left corneal reflex, left facial paresis including the frontalis muscle, absent gag reflex bilaterally,