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Stroke After Minor Head Trauma in Infants and Young Children With Basal Ganglia Calcification: A Lenticulostriate
Jatinder Singh Goraya1, Shivankshi Berry1, Kavita Saggar2
11 Department of Pediatrics, Division of Pediatric Neurology, Ludhiana, Punjab, India.
Insights
Basal ganglia stroke in infants may be linked to calcified arteries and minor head trauma. This condition, basal ganglia calcification, can lead to neurological deficits, though some infants recover.
Area of Science:
- Neurology
- Pediatrics
- Radiology
Background:
- Basal ganglia stroke is a serious condition in infants.
- Calcification in the basal ganglia may indicate underlying vascular abnormalities.
Purpose of the Study:
- To investigate the association between basal ganglia stroke, minor head injury, and basal ganglia calcification in children.
- To identify risk factors and outcomes in pediatric basal ganglia stroke.
Main Methods:
- Retrospective chart review of children diagnosed with basal ganglia stroke.
- Analysis of computed tomography (CT) scans for basal ganglia calcification.
- Review of medical history for preceding minor head trauma.
- Magnetic resonance imaging (MRI) to confirm infarcts.
Main Results:
- Eighteen of twenty pediatric patients with basal ganglia stroke had basal ganglia calcification on CT scans.
- Minor head trauma preceded stroke in 18 patients.
- MRI confirmed basal ganglia infarcts in 18 infants.
- Outcomes varied, with 9 achieving good recovery and 7 having persistent deficits.
Conclusions:
- Basal ganglia calcification, likely representing mineralized lenticulostriate arteries, is a marker for lenticulostriate vasculopathy.
- Abnormal lenticulostriate vessels are susceptible to injury and thrombosis following minor head trauma, leading to stroke.
- Early identification and management are crucial for improving outcomes in pediatric basal ganglia stroke.
Abstract:
The authors retrospectively reviewed charts of the children with basal ganglia stroke who either had preceding minor head injury or showed basal ganglia calcification on computed tomography (CT) scan. Twenty children, 14 boys and 6 girls were identified. Eighteen were aged between 7 months to 17 months. Presentation was with hemiparesis in 17 and seizures in 3. Preceding minor head trauma was noted in 18. Family history was positive in 1 case. Bilateral basal ganglia calcification on CT scan was noted in 18. Brain magnetic resonance imaging done in 18 infants showed acute or chronic infarcts in basal ganglia. Results of other laboratory and radiological investigations were normal. Four infants were lost to follow-up, 9 achieved complete or nearly completely recovery, and 7 had persistent neurological deficits. Basal ganglia calcification likely represents mineralized lenticulostriate arteries, a marker of lenticulostriate vasculopathy. Abnormal lenticulostriate vessels are vulnerable to injury and thrombosis after minor head trauma resulting in stroke.
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