Basal ganglia infarction after mild head trauma in pediatric patients with basal ganglia calcification

Introduction. Basal ganglia calcification (BGC) in pediatric population is rare and is considered as a pathological finding. Various causes may be responsible for BGC including hypoparathyroidism, various infectious, toxicities or hereditary disorders. Aim. We aimed to present a 8 year old boy presented with generalized seizure and bilateral small amount of globus pallidum calcifications on neuroimaging studies leading to the diagnosis of idiopathic hypoparathyroidism, which is a treatable cause of seizure. Description of the case. A 8-year-old boy presented to our emergency department with generalized seizure for the first time in his life. There was no history of previous head trauma and his family history was unremarkable. Neurological examination revealed no pathological findings. Radiological imaging studies revealed only bilateral small amount of globus pallidus calcifications. He was referred to the pediatric endocrinology department for further evaluation of the hypocalcemic convulsion, where laboratory investigations revealed idiopathic hypoparathyroidism as the cause of hypocalcemic convulsion with exclusion of the other causes. Conclusion. Even a small amount of BGC in pediatric patients may be the sign of primary hypoparathyroidism and should be evaluated with serum electrolyte levels for early diagnosis and for the prevention of multisystemic complications of hypoparathyroidism.

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Stroke After Minor Head Trauma in Infants and Young Children With Basal Ganglia Calcification: A Lenticulostriate Vasculopathy?

Journal of Child Neurology ◽

10.1177/0883073817750501 ◽

2018 ◽

Vol 33 (2) ◽

pp. 146-152 ◽

Cited By ~ 7

Author(s):

Jatinder Singh Goraya ◽

Shivankshi Berry ◽

Kavita Saggar ◽

Archana Ahluwalia

Keyword(s):

Basal Ganglia ◽

Ct Scan ◽

Head Trauma ◽

Brain Magnetic Resonance Imaging ◽

Neurological Deficits ◽

Minor Head Trauma ◽

Basal Ganglia Calcification ◽

Lost To Follow Up ◽

Lenticulostriate Vasculopathy

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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Infantile Basal Ganglia Stroke after Mild Head Trauma Associated with Mineralizing Angiopathy of Lenticulostriate Arteries: An Under Recognized Entity

Neuropediatrics ◽

10.1055/s-0038-1649501 ◽

2018 ◽

Vol 49 (04) ◽

pp. 262-268 ◽

Cited By ~ 3

Author(s):

Tamara Avetisyan ◽

Nune Kuyumjyan ◽

Biayna Sukhudyan ◽

Eugen Boltshauser ◽

Annette Hackenberg ◽

...

Keyword(s):

Risk Factors ◽

Basal Ganglia ◽

Head Trauma ◽

Contralateral Side ◽

Deficiency Anemia ◽

Cranial Ultrasound ◽

Minor Trauma ◽

Basal Ganglia Calcification ◽

Recurrent Infarction

AbstractBasal ganglia infarction in young children, mostly after mild head trauma, has been repeatedly reported. The pathogenesis and the risk factors are not fully understood. Lenticulostriate vasculopathy, usually referred to as basal ganglia calcification, is discussed as one of them. We describe five young (7–13 months old on presentation) male children who suffered from hemiparesis due to ischemic stroke of the basal ganglia, four of them after minor head trauma. All of them had calcification in the basal ganglia visible on computed tomography or cranial ultrasound but not on magnetic resonance imaging. Follow-up care was remarkable for recurrent infarction in three patients. One patient had a second symptomatic stroke on the contralateral side, and two patients showed new asymptomatic infarctions in the contralateral basal ganglia on imaging. In view of the scant literature, this clinic-radiologic entity seems under recognized. We review the published cases and hypothesize that male sex and iron deficiency anemia are risk factors for basal ganglia stroke after minor trauma in the context of basal ganglia calcification in infants. We suggest to perform appropriate targeted neuroimaging in case of infantile basal ganglia stroke, and to consider prophylactic medical treatment, although its value in this context is not proven.

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Pediatric Minor Head Trauma: Factors Affecting the Anxiety of Parents

Clinical Pediatrics ◽

10.1177/00099228211009678 ◽

2021 ◽

pp. 000992282110096

Author(s):

Hasan Aldinc ◽

Cem Gun ◽

Serpil Yaylaci ◽

Erol Barbur

Keyword(s):

Computed Tomography ◽

Head Trauma ◽

Pediatric Patients ◽

Positive Impact ◽

Cranial Computed Tomography ◽

Sufficient Information ◽

Minor Head Trauma ◽

Computed Tomography Imaging ◽

Factors Affecting ◽

X Ray

Managing the anxiety of the parents of pediatric patients with head trauma is challenging. This study aimed to examine the factors that affect anxiety levels of parents whose children were admitted to the emergency department with minor head trauma. In this prospective study, the parents of 663 consecutive pediatric patients were invited to answer a questionnaire. Parents of 600 children participated in the study. The parents who believed they were provided sufficient information and who were satisfied with the service received had significantly more improvement in anxiety-related questions. Cranial X-ray assessment had a significantly positive impact on the anxiety of the parents, whereas cranial computed tomography and neurosurgery consultation did not. In assessing pediatric minor head trauma, cranial computed tomography imaging and neurosurgery consultation should not be expected to relieve the anxiety of the parents. However, adequately informing them and providing satisfaction are the factors that could lead to improvement.

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