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

2018 ◽  
Vol 49 (04) ◽  
pp. 262-268 ◽  
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.

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

2018 ◽  
Vol 33 (2) ◽  
pp. 146-152 ◽  
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.

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

2020 ◽  
Vol 192 ◽  
pp. 105706 ◽  
Author(s):  
Wenbin Jiang ◽  
Jinhua Fu ◽  
Fang Chen ◽  
Qijia Zhan ◽  
Yanyan Wang ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Head Trauma ◽  
Pediatric Patients ◽  
Basal Ganglia Calcification

scholarly journals Evaluation of Risk Factors and Treatment of Peri-Partum Anemia

2021 ◽  
Author(s):  
Safaa A. Ibrahim ◽  
Mena M. Abdalla ◽  
Rofida M. Elshafei
Keyword(s):  
Risk Factors ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Post Partum ◽  
Demographic Data ◽  
Deficiency Anemia ◽  
Folate Supplementation ◽  
Estimated Blood Loss ◽  
The World

Abstract Iron deficiency anemia (IDA) in pregnancy, i.e., prepartum anemia, is associated with premature birth, low birth weight, and small for gestational age of the newborn and is furthermore closely associated with the occurrence of anemia after delivery of a child, i.e., in the postpartum period .Post partum anemia is a common problem throughout the world. Through this study, aim of the work (frequency of post partum anemia and risk factors for its development) & objectives was done. The study showed that percentage of antepartum anemia was about 64.3% this percentage postpartum increased to about 65.4% and 13.6% of those with antepartum normal hemoglobine level became anemic and there were 12.5% anemic improved postpartum and became normal. The major causes of postpartum anemia are prepartum iron deficiency/anemia in combination with excessive blood losses at delivery. Post partum anemia is not affected by demographic data, obstetric history, ante-partum u/s and partum history. Antepartum hemorrage was not significantly associated with postpartum anemia. The more the estimated blood loss during labor the more the postpartum anemia. Through follow up of post partum anemia cases and treated it according type of anemia (oral, intravenous, folate supplementation and blood transfusion) Outcome of treatment of anemia after 8 weeks 61.02 % is improved & 38.98% is not improved.Conclusion: The major causes of postpartum anemia are prepartum iron deficiency/anemia in combination with excessive blood losses at delivery. The study showed that percentage of antepartum anemia was about 64.3% this percentage postpartum increased to about 65.4% and 13.6% of those with normal antepartum hemoglobine level became anemic postpartum and there were 12.5% anemic improved postpartum and became normal.

scholarly journals Analysis of Risk Factors, Localization and 30-day Prognosis of Intracerebral Hemorrhage

2008 ◽  
Vol 8 (2) ◽  
pp. 121-125 ◽  
Author(s):  
Dževdet Smajlović ◽  
Denisa Salihović ◽  
Omer Ć. Ibrahimagić ◽  
Osman Sinanović ◽  
Mirjana Vidović
Keyword(s):  
Risk Factors ◽  
Basal Ganglia ◽  
Intracerebral Hemorrhage ◽  
Heart Diseases ◽  
Medical Science ◽  
Internal Capsule ◽  
Stroke Severity ◽  
Cerebellar Hemorrhage ◽  
Sex Risk

Intracerebral hemorrhage is the deadliest, most disabling and least treatable form of stroke despite progression in medical science. The aim of the study was to analyze the frequency, risk factors, localization and 30-day prognosis in patients with intracerebral hemorrhage.We analyzed 352 patients with intracerebral hemorrhage (ICH) hospitalized at the Department of Neurology Tuzla during a three-year follow up. The following data were collected for all patients in a computerized database: age, sex, risk factors (hypertension, heart diseases, diabetes and smoking) and CT findings. Stroke severity was estimated with Scandinavian Stroke Scale, ICH topography was specified by CT, and outcome at 1st month after onset included information on vital status and disability (modified Rankin Scale, mRS).The most frequent risk factors were hypertension (84%), heart diseases (31%), cigarette smoking (28%) and diabetes mellitus (14%). The most frequent localization of ICH was multilobar (38%), internal capsule/basal ganglia region (36%) and lobar (17%). Within first month died 147 patients (42%). The highest mortality rate was in patients with brain stem (83%) and multilobar hemorrhage (64%). Factors independently associated with mortality were age (odds ratio 1,05 (95% confidence interval 1,02 to 1,08); p=0,001), stroke severity (OR 0,93 (0,92 to 0,95); p<0,0001), multilobar hemorrhage (OR 5,4 (3,0 to 9,6); p<0,0001) and intraventricular hemorrhage (OR 3,9 (2,2 to 7,1); p<0,0001). Favorable outcome at first month (mRS <2) had 45% of the surviving patients with ICH. The best outcome was for the patients with cerebellar hemorrhage (63%), while only 40% of the patients with hemorrhage in internal capsule/basal ganglia region had Rankin scale 2 or less.Hypertension is the most frequent risk factor in patients with ICH. ICHs are mainly localized in lobar and internal capsule/basal ganglia regions. Independent predictors of mortality following ICH are age, hypertension, intraventricular blood extension and stroke severity. Mortality, as well as good outcome at 1 month, is related to the localization of bleeding.

scholarly journals Identification of risk factors in infants participating in a Follow-up program

Revista CEFAC ◽  
2018 ◽  
Vol 20 (3) ◽  
pp. 333-341 ◽  
Author(s):  
Cibelle Kayenne Martins Roberto Formiga ◽  
Laryssa Pereira da Silva ◽  
Maria Beatriz Martins Linhares
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Hospital Stay ◽  
Apgar Score ◽  
Binary Logistic Regression ◽  
Biological Data ◽  
Cranial Ultrasound ◽  
Male Sex ◽  
High Risk Infants

ABSTRACT Purpose: to identify the main health risk factors of infants participating in a follow-up program. Methods: a longitudinal prospective study conducted with 540 high-risk infants observed in the follow-up clinic of the Hospital Materno Infantil in Goiânia in the State of Goiás, Brazil. All biological data of the infants from birth, prenatal, and postnatal periods were collected through assessment sessions with their mothers and medical chart reviews. Data were analyzed through binary logistic regression to identify the highest-risk variables for the infants’ health. Results: in a predictive analysis, the findings showed that neonatal risk was statistically associated with a lower Apgar score at the fifth minute of life, male infants, and longer hospital stay. Infants with increased neonatal risk were more likely to show alterations identified in cranial ultrasound examinations. Moreover, the longer hospital stay was related to mixed breastfeeding after discharge. Conclusion: the main risk factors for the health of high-risk infants in the follow-up program were: low Apgar score at the fifth minute; male sex; longer hospital stay; alterations detected in transfontanellar ultrasound; and mixed feeding after discharge.

scholarly journals Basal Ganglia Germ Cell Tumors With or Without Sellar Involvement: A Long-Term Follow-Up in a Single Medical Center and a Systematic Literature Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Yi Zhang ◽  
Li Wang ◽  
Wenbin Ma ◽  
Hui Pan ◽  
Renzhi Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Basal Ganglia ◽  
Literature Review ◽  
Germ Cell ◽  
Medical Center ◽  
Germ Cell Tumors ◽  
Delayed Diagnosis ◽  
Tumor Dissemination ◽  
Prognostic Risk Factors

BackgroundBasal ganglia germ cell tumors (BGGCTs) represent an extremely rare subset of tumors about which little is known. Some patients suffer from tumor dissemination, such as sellar involvement. This study aimed to evaluate the independent prognostic risk factors of patients with BGGCTs with or without sellar involvement.MethodsSixteen patients were diagnosed with BGGCTs at Peking Union Medical College Hospital from January 2000 to December 2020. A literature review was performed on the online databases Medline and PubMed, and 76 cases in the 19 retrieved articles were identified at the same time. The data regarding biochemical tests, radiological examinations, and outcomes during follow-up were analyzed.ResultsOf 92 patients in this study, seven patients were clinically diagnosed as germinomas, with the remaining 85 patients receiving surgery. Fifty-two patients suffered from multifocal lesions or tumor dissemination. The patients with BGGCTs demonstrated a significant male predilection. The patients with delayed diagnosis more likely had cognitive disturbance (p = 0.028), mental disturbance (p = 0.047), and diabetes insipidus (p = 0.02). Multivariate analysis demonstrated that the independent poor prognostic risk factors of patients with BGGCTs were delayed diagnosis [odd ratio (OR) 2.33; 95% CI 1.02–5.31], focal radiotherapy (OR 4.00; 95% CI 1.69–9.49), and non-pure germinoma (OR 4.64; 95% CI 1.76–12.22).ConclusionsThe delayed diagnosis, focal radiotherapy, and non-pure germinoma were associated with a poorer prognosis for patients with BGGCTs with or without sellar involvement.

scholarly journals Basal Ganglia Calcification in Hypoparathyroidism Is Associated With Low Serum Calcium/Phosphate Ratio

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A255-A256
Author(s):  
Guido Zavatta ◽  
Peter J Tebben ◽  
Bart Lyman Clarke
Keyword(s):  
Risk Factors ◽  
Basal Ganglia ◽  
Calcium Phosphate ◽  
Serum Calcium ◽  
Weighted Average ◽  
Ct Scans ◽  
Basal Ganglia Calcification ◽  
Head Ct ◽  
Time Weighted Average ◽  
Low Serum

Abstract Background: Basal ganglia calcification (BGC) is a well-known complication of hypoparathyroidism. It is currently thought that increased serum phosphate or calcium x phosphate product may be major risk factors. However, the pathophysiology of BGC is still unclear, since the literature is largely based on limited case series or case reports. Methods: We identified a large cohort of patients with hypoparathyroidism diagnosed between 2000 and 2020 and evaluated those with head CT scans performed over this interval. Etiology and date of onset of hypoparathyroidism were determined by medical records review. All head CT scan images were reviewed to confirm radiology reports reporting BGC. We retrieved laboratory data within 10 years before the first head CT that showed incident BGC. Three age- and sex- matched controls with head CT scans were selected for each patient, and compared to the patients with hypoparathyroidism. Results: Of 1014 unique patients with a verified diagnosis of hypoparathyroidism, 142 had a head CT scan performed between 2000 and 2020. Head CT scans were performed for reasons unrelated to hypoparathyroidism in 96.5% of patients. In this cohort, 80.3% of patients (n=114) had post-surgical hypoparathyroidism. Age at which the first head CT in patients was done was 62±20.6 (range 11–97), and duration of hypoparathyroidism at the time of first head CT was 11.0±14.4 years (0–71). Prevalence of BGC in patients with hypoparathyroidism was 25.4% (n=36), as compared with 7.3% in the control group (31/426) (P&lt;0.001). Patients and controls were similar in terms of cardiovascular risk factors (diabetes, hypertension, dyslipidemia, alcohol consumption, smoking status and BMI). In patients with non-surgical hypoparathyroidism (n=28), prevalence of BGC was 71.4% vs. 14.0% in the postsurgical cohort (OR 15.4; 95% CI 5.8–40, P&lt;0.001). Compared to patients with hypoparathyroidism without BGC, those with BGC had lower time-weighted average serum calcium (8.4±0.8 vs. 8.8±0.8, P=0.002; normal range, 8.6–10.2 mg/dL), and lower time-weighted average calcium/phosphate ratio (Ca/P) (1.83±0.52 vs. 2.13±0.47, P=0.007). Conclusions: Basal ganglia calcification in hypoparathyroidism is associated with low serum calcium and low Ca/P ratio. This may allow increased bioavailability of phosphate in the extracellular space, leading to calcium phosphate crystal formation within the basal ganglia. Assessing Ca/P ratio may be useful to identify patients at risk for BGC. Prevalence of BGC is significantly higher in patients with non-surgical hypoparathyroidism.

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