Abstract
Ischemia of the basal ganglia as an immediate consequence of minor head injury in children is rare (< 2% of all ischemic stroke in childhood) and is due to vasospasm of the lenticulostriate arteries. The clinical history of these lesions is particularly favourable because they are usually small, and also because the facial-brachial-crural hemiparesis typical of this pathology usually regresses after a period ranging from several weeks to several months, despite the persistence of an ischemic area on MRI. This is due to the well known neuronal plasticity of the CNS, in particular, of the primary motor cortex. The most effective therapeutic approach appears to be the conservative one, although the best treatment regimen is still not well defined.Young patients should be closely monitored and treated conservatively with osmotic diuretics to reduce perilesional edema. At the same time, however, it is very important to exclude, by means of instrumental and laboratory studies, conditions that could favour the onset of ischemia, including emboligen heart disease, thrombophilia and acute traumatic arterial dissections. Generally speaking, the prognosis in these cases is good. The authors describe their experience treating a 10-month old baby girl, with a left lenticular nucleus ischemia and report a literature review.
Highlights
Ischemia of the basal ganglia as an immediate consequence of minor head trauma in children under 18 months of age is a rare eventuality (< 2% of all ischemic stroke in childhood) [1], it is caused by vasospasm of the lenticulostriate arteries, frequent in childhood, which are disrupted by head injury
We report the case of a 10 month old child who presented an acute ischemic lesion of the left lenticular nucleus, after a minor head trauma
All of them were studied by brain MRI that showed ischemia involving the left internal capsule and corona radiate ischemia in 3 cases, the right lentiform nucleus and the corona radiate in 3, the bilateral basal ganglia, internal capsule and periventricular white matter in 1, the internal capsule in 1 and the lentiform nucleus in 1
Summary
Ischemia of the basal ganglia as an immediate consequence of minor head trauma in children under 18 months of age is a rare eventuality (< 2% of all ischemic stroke in childhood) [1], it is caused by vasospasm of the lenticulostriate arteries, frequent in childhood, which are disrupted by head injury. It manifests with nausea, vomiting, hemiparesis and drowsiness, a clinical picture known as JHTS syndrome (Juvenile Head Trauma Syndrome) [2]. The ensuing facio-brachio-crural hemiparesis improved over time until complete regression of symptoms 45 days later
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
