An 8-year-old boy presented with symptoms compatible with a right inte
rnuclear ophthalmoplegia. Magnetic resonance imaging showed a high-int
ensity signal on T2-weighted images at the level of the medial longitu
dinal fasciculus. Laboratory evaluation was positive only for sickle c
ell trait. Sickle cell trait is an uncommon cause for brainstem infarc
tion.