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Can mild head injury cause ischaemic stroke?
L Shaffer1, P M Rich, K R E Pohl
1Neurosciences Unit, Institute of Child Health, University College, London WC1N 1EH, UK.
Archives of Disease in Childhood
|February 25, 2003
Summary
Minor head trauma can cause ischemic stroke in children, particularly striatocapsular infarction. While most recovered well, the exact cause in susceptible children remains unclear, possibly involving genetic or environmental factors.
Area of Science:
- Neurology
- Pediatrics
- Vascular Medicine
Background:
- Ischemic stroke in children is uncommon.
- Cerebrovascular abnormalities and risk factors are often absent in pediatric stroke.
- Head trauma is an underrecognized trigger for stroke in children.
Observation:
- Five pediatric cases of ischemic stroke following minor head trauma were analyzed.
- All patients presented with striatocapsular infarction.
- Cerebrovascular imaging revealed no abnormalities in three patients, while two showed turbulent flow in the middle cerebral artery.
Findings:
- No evidence of arterial dissection or other typical stroke risk factors was found.
- All children experienced excellent neurological recovery.
- Potential mechanisms include mechanical disruption, intimal trauma leading to thrombosis, or trauma-induced arterial spasm.
Implications:
- Minor head trauma should be considered a potential cause of ischemic stroke in children.
- The underlying susceptibility in children requires further investigation, possibly involving genetic or environmental factors.
- Understanding these mechanisms can inform stroke prevention and management strategies in pediatric populations.