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.
DharkerSRMittalRSBhargavaN. Ischemic lesions in basal ganglia in children after minor head injury. Neurosurgery. 1993;33:863–865.
2.
ShafferLRichPMPohlKREGanesanV. Can mild head injury cause ischaemic stroke?Arch Dis Child. 2003;88:267–269.
3.
JauhariPSankhyanNKhandelwalNSinghiP. Childhood basal ganglia stroke and its association with trivial head trauma. J Child Neurol. 2015;31:738–742.
4.
KieslichMFiedlerAHellerCKreuzWJacobiG. Minor head injury as cause and co-factor in the aetiology of stroke in childhood: a report of eight cases. J Neurol Neurosurg Psychiatry. 2002;73:13–16.
5.
AnggriawanSLMangunatmadjaIGatotDIsmaelSAdvaniN. Risk factors and outcomes, a cases series of ischemic stroke in children. Paediatr Indones. 2009;49;59–64.
6.
OkunoTTakaoTItoMKonishiYMikawaHNakanoY. Infarction of the internal capsule in children. J Comput Assist Tomogr. 1980;4:770–774.
7.
MakiYAkimotoHEnomotoT. Injuries of basal ganglia following head trauma in children. Child’s Brain. 1980;7:113–123.
8.
MuthukumarN, Basal ganglia-internal capsule low density lesions in children after mild head injury. Br J Neurosurg. 1996;10:391–393.
9.
RanaKSBeheraMKAdhikariKM. Ischemic stroke following mild head injury: Is it the cause?Indian Pediatr. 2006;43:994–997.
10.
BuompadreMCArroyoHA, Stroke Group. Basal ganglia and internal capsule stroke in childhood-risk factors, neuroimaging, and outcome in a series of 28 patients: a tertiary hospital experience. J Child Neurol. 2009;24:685–691.
11.
IshiharaCSawadaKTatenoA. Bilateral basal ganglia infarction after mild head trauma. Pediatr Int. 2009;51:829–831.
12.
YangF-HWangHZhangJ-MLiangH-Y. Cerebral infarction after mild head trauma in children. Indian Pediatr. 2013;50:875–878.
13.
LingappaLVarmaRDSiddaiahgariSKonankiR. Mineralizing angiopathy with infantile basal ganglia stroke after minor head trauma. Dev Med Child Neurol. 2014;56:78–84.
14.
KamateMMalhotraMGangammaDHHattiholiV. Acute encephalopathy: a novel presentation of mineralizing microangiopathy of childhood. Ann Indian Acad Neurol. 2016;19:528–530.
15.
JainPKishorePBhasinJSAryaSC. Mineralizing angiopathy with basal ganglia stroke in an infant. Ann Indian Acad Neurol. 2015;18:233–234.
16.
AroraAJBollaHAroraRKaulSYarlagaddaJ. Basal ganglia infarction due to mild head trauma in a case of mineralizing angiopathy: a rare entity. Neurol India. 2015;63:771–772.
17.
KayaTOzkanRBozogluNAdapinarBYakutA. Basal ganglia infarcts with calcifications in children. Eur J Radiol. 1995;20:48–51.
18.
YangF-HWangHZhangJ-MLiangH-Y. Clinical features and risk factors of cerebral infarction after mild head trauma under 18 months of age. Pediatr Neurol. 2013;48:220–226.
19.
IvanovIZlatarevaDPachevaIPanovaM. Does lenticulostriate vasculopathy predispose to ischemic brain infarct? A case report. J Clin Ultrasound. 2012;40:607–610.
20.
YangS-TLeeW-THungK-LChangC-L. Infantile basal ganglia stroke after mild head trauma. Neurology. 2015;84:2381–2382.
21.
ChangC-L. Clinical significance of lenticulostriate vasculopathy. ARC J Pediatr. 2016:2:4–8.
22.
WangH-SKuoM-FChangT-C. Sonographic lenticulostriate vasculopathy in infants: some associations and a hypothesis. AJNR Am J Neuroradiol. 1995;16:97–102.
23.
SismanJRosenfeldCR. Lenticulostriate vasculopathy in neonates: is it a marker of cerebral insult? Critical review of literature. Early Hum Dev. 2015;91:423–426.
HemachandraAHOravecDCollinMTafariNMhannaMJ. Early and late postnatal identification of isolated lenticulostriate vasculopathy in preterm infants. Associated findings. J Perinatol. 2003;23:20–23.
26.
KoralKSismanJPritchardMRosenfeldCR. Lenticulostriate vasculopathy in neonates: perspective of the radiologist. Early Hum Dev. 2015;91:431–435.
27.
TeeleRLHernanz-SchulmanMSotrelA. Echogenic vasculature in the basal ganglia of neonates: a sonographic sign of vasculopathy. Radiology. 1988;169:423–427.
28.
WeberKRiebelTNasirR. Hyperechoic lesions in the basal ganglia: an incidental sonographic finding in neonates and infants. Pediatr Radiol. 1992;22:182–186.
29.
Maayan-MetzgerALeibovitchLSchushan-EisenISoudackMStraussT. Risk factors and associated diseases among preterm infants with isolated lenticulostriate vasculopathy. J Perinatol. 2016;36:775–778.
30.
El AyoubiMde BethmannOMonset-CouchardM. Lenticulostriate echogenic vessels: clinical and sonographic study of 70 neonatal cases. Pediatr Radiol. 2003;33:697–703.
31.
HagmannCFRoberstonNJAcoletD. Cranial ultrasound findings in well newborn Ugandan infants. Arch Dis Child Fetal Neonatal Ed. 2010:95:F338–344.
32.
MazmanyanPKerobyanVNikoghosyanK. Cranial ultrasound findings in asymptomatic full term infants. Arch Dis Child. 2014;99(suppl 2):A383.
33.
KashmanNKramerUStavorovskyZ, etal. Prognostic significance of hyperechogenic lesions in the basal ganglia and thalamus in the neonates. J Child Neurol. 2001;16:591–594.
