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.

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.

Neurological deficits are associated with increased brain calcinosis, hypoperfusion, and hypometabolism in idiopathic basal ganglia calcification

2007 ◽  
Vol 22 (7) ◽  
pp. 1027-1030 ◽  
Author(s):  
Misuzu Saiki ◽  
Shinji Saiki ◽  
Koichiro Sakai ◽  
Ichiro Matsunari ◽  
Kotaro Higashi ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Neurological Deficits ◽  
Basal Ganglia Calcification ◽  
Idiopathic Basal Ganglia Calcification

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 Cavernous Malformation of Brainstem, Thalamus, and Basal Ganglia

Neurosurgery ◽  
2012 ◽  
Vol 72 (4) ◽  
pp. 573-589 ◽  
Author(s):  
Paritosh Pandey ◽  
Erick M. Westbroek ◽  
Peter A. Gooderham ◽  
Gary K. Steinberg
Keyword(s):  
Basal Ganglia ◽  
Neurological Deficits ◽  
Term Outcome ◽  
Cavernous Malformations ◽  
Long Term Outcome ◽  
Brain Malformations ◽  
Hemorrhage Risk ◽  
Clinical Records

Abstract BACKGROUND: Cavernous malformations (CMs) in deep locations account for 9% to 35% of brain malformations and are surgically challenging. OBJECTIVE: To study the clinical features and outcomes following surgery for deep CMs and the complication of hypertrophic olivary degeneration (HOD). METHODS: Clinical records, radiological findings, operative details, and complications of 176 patients with deep CMs were reviewed retrospectively. RESULTS: Of 176 patients with 179 CMs, 136 CMs were in the brainstem, 27 in the basal ganglia, and 16 in the thalamus. Cranial nerve deficits (51.1%), hemiparesis (40.9%), numbness (34.7%), and cerebellar symptoms (38.6%) presented most commonly. Hemorrhage presented in 172 patients (70 single, 102 multiple). The annual retrospective hemorrhage rate was 5.1% (assuming CMs are congenital with uniform hemorrhage risk throughout life); the rebleed rate was 31.5%/patient per year. Surgical approach depended on the proximity of the CM to the pial or ependymal surface. Postoperatively, 121 patients (68.8%) had no new neurological deficits. Follow-up occurred in 170 patients. Delayed postoperative HOD developed in 9/134 (6.7%) patients with brainstem CMs. HOD occurred predominantly following surgery for pontine CMs (9/10 patients). Three patients with HOD had palatal myoclonus, nystagmus, and oscillopsia, whereas 1 patient each had limb tremor and hemiballismus. At follow-up, 105 patients (61.8%) improved, 44 (25.9%) were unchanged, and 19 (11.2%) worsened neurologically. Good preoperative modified Rankin Score (98.2% vs 54.5%, P = .001) and single hemorrhage (89% vs 77.3%, P < .05) were predictive of good long-term outcome. CONCLUSION: Symptomatic deep CMs can be resected with acceptable morbidity and outcomes. Good preoperative modified Rankin Score and single hemorrhage are predictors of good long-term outcome.

Can a CT be Omitted in Pediatric Minor Head Trauma?

2017 ◽  
Vol 16 (01) ◽  
pp. 001-007
Author(s):  
Maria Sinzig ◽  
Eveline Achatz ◽  
Günter Fasching ◽  
Christoph Arneitz
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Head Trauma ◽  
Neurological Status ◽  
Ct Scans ◽  
Minor Head Trauma ◽  
Pediatric Ct ◽  
Ct Protocol ◽  
In Infants And Children

AbstractThis study aimed to evaluate the need for radiation exposure in pediatric minor head trauma. Symptomatic patients after minor head trauma were observed for at least 24 hours in a 13-month period. A computed tomography (CT) scan was performed on children with a depressed neurological status. Two hundred fourteen patients with a mean age of 9.3 years were included. An intracranial hemorrhage (ICH) was diagnosed in three (1.4%) patients. The overall CT rate was 10.7%. The study concluded that neuro-observation without initial CT scans is safe in infants and children following minor head trauma. Special pediatric CT protocol can limit radiation exposure.

scholarly journals Does my child really need a CT Scan? A retrospective review of use of CT Scan in minor head trauma

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Kashgari A ◽  
Al Rajeh A ◽  
Abdulrahman S ◽  
Alrasheed E ◽  
AL Faleh H ◽  
...  
Keyword(s):  
Ct Scan ◽  
Head Trauma ◽  
Retrospective Review ◽  
Minor Head Trauma
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