Abstract
:Infarction of the basal ganglia after minor head injury �is a� well described entity .�Mineralising angiopathy� is a term to describe mineralisation along� the lenticulostriate vessels that predisposes infants to stroke,even after trivial head injury.(1)The prognosis in these children is excellent.The supratentorial compartment is relatively mobile in comparision to the fixed infratentorial compartment �offering greater shearing forces between the perforating vessels and the brain parenchyma following �an acute trauma.(2)The acute angulation of the lenticulostriate perforators is further responsible for its propensity of the basal ganglia for the insult.(3) The current report is unique as it presents a young boy with hemorrhagic stroke in the�� basal ganglia after a trivial trauma and �imaging findings suggestive of mineralising angiopathy
Highlights
Infarction of the basal ganglia after minor head injury is a well-described entity
We present a young boy with hemorrhagic stroke in the basal ganglia after a trivial trauma and with imaging findings suggestive of mineralising angiopathy
Investigations showed hemoglobin of 12.5g/dL, a normal differential white blood cell count and platelets, and no evidence of coagulopathy. His vasculitic profile included the presence of titres in the serum antinuclear antibodies (ANAs), antibodies to extractable nuclear antigens (ENAs), anti-native DNA antibodies, topoisomerase I antibodies (Scl-70), antibodies to cyclic citrullinated peptides, rheumatoid factor (RA factor), C-ANCA and p-ANCA levels, which were normal
Summary
Infarction of the basal ganglia after minor head injury is a well-described entity. ‘Mineralising angiopathy’ is a term to describe mineralisation along the lenticulostriate vessels (LSV) and is usually seen after a trivial head injury with a presentation as acute stroke [1].The prognosis in these children is excellent. The acute angulation of the lenticulostriate perforators is another postulate, suggesting the propensity of the basal ganglia for the insult [3] In this case report, we present a young boy with hemorrhagic stroke in the basal ganglia after a trivial trauma and with imaging findings suggestive of mineralising angiopathy. Investigations showed hemoglobin of 12.5g/dL, a normal differential white blood cell count and platelets, and no evidence of coagulopathy His vasculitic profile included the presence of titres in the serum antinuclear antibodies (ANAs), antibodies to extractable nuclear antigens (ENAs), anti-native DNA antibodies (anti-DNA), topoisomerase I antibodies (Scl-70), antibodies to cyclic citrullinated peptides (anti-CCP), rheumatoid factor (RA factor), C-ANCA (myeloperoxidase) and p-ANCA (proteinase 3) levels, which were normal. This report is unique as it highlights the presence of hemorrhagic stroke following a trivial trauma, with an excellent recovery in a young child Vascular anomalies such as arterio-venous malformations are a differential, but was thoroughly ruled out by the digital subtraction angiographic study. Traumatic dissection of the lenticulostriate vessels leading to hemorrhage could be another possibility [5]
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