Post Traumatic Basal Ganglia Infarction in Children of Eastern India

Abstract

Introduction: Post traumatic infarction in children is an uncommon event after head injury in children, makes for less than 2% of all pediatric ischemic strokes.

Aims: This case series aims to study the clinical profile of patients with posttraumatic basal ganglia infarction, imaging abnormalities. Associated risk factors and to assess outcome.

Material and Methods: We report 14 cases of posttraumatic basal ganglia infarction. All patients were children below 13 years of age. Majority of them had minor head injury after fall, only two patients presented after road traffic accident (RTA). All patients were investigated according to protocol with CT head; both magnetic resonance angiography and a small number of patients had magnetic resonance imaging (MRI) procedures. Carotid Doppler and 2-D echocardiography was performed to rule out embolic source. Screening for haematological or biochemical abnormalities was done by complete blood count, coagulation profile, ESR, CRP. RA factor, ASO titers etc. All patients were treated conservatively. Outcome was assessed with Glasgow outcome scale. Patients were followed up to 6 months.

Results: Nine of the 14 cases were men, and five were women. The mean age was3 years (range: 9 months to 12 years). 12 of them had minor head injury after fall, only two patients presented after RTA. None of the patients had previous history of seizures or heart disease. Two patients had history of fever preceding fall.

Conclusion: Most of the patients may not have any predisposing conditions but it is mandatory to exclude other causes of ischemia like embolic source in heart, acute traumatic arterial dissections or any thrombophilic states. Most of the patients will have complete recovery attributable to childhood neuronal plasticity.