The significant danger of minor trauma in pediatric patients: acute ischemic stroke

Minor head trauma is a common reason for pediatric admissions to emergency departments and typically does not necessitate further diagnostic evaluation. However, there is a rare but significant risk of ischemic stroke following such trauma, making neuroimaging crucial in selected cases. In this case series, we assessed six pediatric patients diagnosed with ischemic stroke after experiencing minor head trauma in our clinic. The patients ranged in age from 9 to 56 months, including four boys and two girls. Each patient presented with focal neurological deficits within the first 72 h post-injury. No signs of intracranial hemorrhage or fractures were identified, and laboratory tests revealed no additional abnormalities. Two of the patients required decompression surgery due to neurological deterioration during follow-up, both of whom had a poor prognosis. In contrast, the remaining four patients exhibited diffusion restriction in the basal ganglia and made full recoveries with conservative treatment. Acute ischemic stroke following minor head trauma can lead in significant morbidity and mortality, although the underlying mechanisms remain unclear. It is essential for clinicians to consider acute ischemic stroke in the differential diagnosis for patients displaying neurological symptoms that are inconsistent with the severity of their trauma. In suspected cases, early neuroimaging with cranial MRI and BT/MR angiography plays a critical diagnostic role and may be life-saving.