Ischemic stroke due to minor head trauma in a child: a case report

Year 2019, Volume: 5 Issue: 2, 421 - 423, 04.03.2019

Suna Eraybar , Yalçın Katı Serhat Atmaca Gökhan Torun Yasemin Nennicioğlu

https://doi.org/10.18621/eurj.396188

Abstract

Head
trauma usually causes hemorrhage, but in children ischemia of basal ganglia may
develop. Traumatic stroke occasionally develops after dissection of brain
vessels, leading to disseminated cerebral embolism. Stretching forces in
cerebral intraparenchymal arteries can cause vascular damage followed by an
occluding thrombus. An 18-month-old girl presented to our emergency department
with the complaint of head trauma after falling down while playing. Her parents
recognized the weakness of her left site extremity after 6 hours after the
event. After initial physical examination and further imaging studies brain
magnetic resonance imaging (MRI) showed an infarct affecting the caudate
nucleus in the right cerebral hemisphere. In childhood, ischemic stroke due to
mild head trauma is an exceedingly rare event and may be overlooked in
emergency medicine practice. We aimed to emphasize that mild head trauma may
cause critical situations such as acute infarct in children.  

Keywords

cerebral infarction, head trauma, traumatic stroke

References

• [1] Shaffer L, Rich PM, Pohl KR, Ganesan V. Can mild head injury cause ischaemic stroke? Arch Dis Child 2003;88:267-9.
• [2] Klieslich M, Fieldler A, Heller C. 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;73:13-6.
• [3] Kirkham FJ, Prengler M, Hewes DK, Ganesan V. Risk factors for arterial ischemic stroke in children. J Child Neurol 2000;15:299-307.
• [4] Kochanek PM. Pediatric traumatic brain injury: quo vadis? Dev Neurosci 2006;28:244-55.
• [5] Seçkin H, Demirci AY, Değerliyurt A, Dağli M, Bavbek M. Post traumatic infarction in the basal ganglia after a minor head injury in a child: case report. Turk Neurosurg 2008;18:415-9.
• [6] Nowak-Gottl U, Strater R, Heinecke A, Junker R, Koch HG, Schuierer G, et al. Lipoprotein(a) and genetic polymorphisms of clotting factor V, prothrombin, and methylenetetrahydrofolate reductase are risk factors of spontaneous ischemic stroke in childhood. Blood 1999;94:3678-82.
• [7] Zenz W, Bodo Z, Plotho J, Streif W, Male C, Bernert G, et al. Factor V Leiden and prothrombin gene G 20210 A variant in children with ischemic stroke. Thromb Haemost 1998;80:763-6.
• [8] McColl MD, Chalmers EA, Thomas A, Sproul A, Healey C, Rafferty I, et al. Factor V Leiden, prothrombin 20210G A, and the MTHFR C677T mutations in childhood stroke. Thromb Haemost 1999;81:690-4.