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Cerebral white matter lacerations in children caused by repetitive head trauma
Yuka Murofushi1, Kimiko Hosoyama2, Kazuo Kubota3
1Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Japan.
Insights
Repetitive head trauma in children can cause cerebral white matter (WM) lacerations, leading to neurological symptoms. This study highlights acquired WM lesions in teenagers, suggesting childhood head trauma as a cause.
Area of Science:
- Neurology
- Pediatrics
- Radiology
Background:
- Cerebral white matter (WM) lacerations are known in infants under one year following head trauma.
- Previous literature lacks reports on similar WM lesions in individuals over one year of age.
Observation:
- Three teenage boys (11, 12, and 18 years) presented with acquired cerebral WM lacerations.
- These lacerations were associated with recurrent head trauma and resulted in neurological symptoms.
- Symptoms included spastic paralysis, afebrile convulsions, and cognitive impairment.
Findings:
- Two patients diagnosed with autism spectrum disorder had a history of severe self-inflicted head trauma from preschool age.
- A third patient, involved in martial arts and boxing from preschool age, exhibited declining intellectual ability.
- Brain MRI revealed severe bilateral cerebral WM lacerations, with evidence suggesting acquisition in childhood.
Implications:
- Recurrent head trauma in children may lead to acquired cerebral WM lacerations.
- Childhood head trauma can result in significant brain dysfunction and neurological deficits.
- This study underscores the importance of recognizing the long-term consequences of head trauma in pediatric populations.
Abstract:
It has been known that infants less than 1 year develop cerebral white matter (WM) lacerations associated with head trauma, however, there has been no report of similar WM lesions over 1 year. We report three teenage boys (11, 12, and 18 years at final MRI studies) with acquired WM lacerations associated with recurrent head trauma who developed neurologic symptoms such as spastic paralysis, afebrile convulsions, and cognitive impairment. Two of them (patients 1 and 2) were given a diagnosis of autism spectrum disorder and had a history of repeated severe self-inflicted head trauma from preschool age. Patient 3, who practiced karate and boxing from preschool age, showed gradual declining intellectual ability. Brain MRI of the three patients revealed severe lacerations in the bilateral cerebral WM. Previous neuroimaging showed no WM lacerations at 4 and 5 years in patients 1 and 2, or mild WM lacerations at 17 years in patient 3, indicating the WM lacerations could have been acquired in childhood. It is suggested that repetition of head trauma in children can cause cerebral WM lacerations and brain dysfunction.
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