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Ischemic cerebellar infarct in a 5-year-old boy: sequela to minor back trauma
Insights
Minor trauma can cause ischemic cerebellar infarct in children. This case highlights the importance of considering post-traumatic stroke in pediatric patients presenting with vomiting, headache, and ataxia, with potential benefit from short-term glucocorticoid therapy.
Area of Science:
- Pediatric Neurology
- Neuroscience
- Trauma Research
Background:
- Cerebellar infarcts are rare in children.
- Traumatic injuries can precipitate cerebrovascular events.
- Vomiting, headache, and ataxia are key symptoms requiring differential diagnosis.
Abstract:
Minor trauma, a kick to the center of the back during roughhousing with an 8-year-old sibling, produced an ischemic cerebellar infarct in a 5-year-old boy. The boy was brought to medical attention because of vomiting and headache. He also had ataxia. Results of laboratory studies, structural examination, and cerebrospinal fluid analysis were noncontributory. An irregular, low-density region in the left cerebellar hemisphere of unknown cause was seen on computed tomography scans. Magnetic resonance imaging (MRI) revealed an area of signal alteration hyperintense on the T2-weighted image and mildly hyperintense on the proton-density image in the leftward cerebellar hemisphere. The distribution was most compatible with that of an acute superior cerebellar arterial infarction. No other abnormalities were detected. The patient was treated with oral prednisolone, recovered, and had no further episodes or sequelae. The authors recommend that post-traumatic stroke be considered early in the differential diagnosis of a child with the triad of symptoms seen in the patient described. They suggest that glucocorticoid therapy on a short-term basis may have a place in more rapid resolution of symptoms.