Posttraumatic infarction in the territory supplied by the lateral lenticulostriate artery after minor head injury.
BACKGROUND
Occlusion of the intracranial arteries due to blunt head traumas has been less frequently observed in patients with minor head injuries.


METHODS
A 4-year-old boy presented with speech disturbance 2 h after minor head injury. An initial computed tomography (CT) scan showed a questionable finding of a focal punctate high density in the left basal ganglia. Hemiparesis developed on the right limbs 8 h post-injury, and a subsequent CT scan revealed a discrete low-density change around the focal high density. Diffusion-weighted images revealed a clearly demarcated high-signal intensity lesion in similar area on T2-weighted and fluid-attenuated inversion recovery sequences images, compatible with infarcted tissues on the territory supplied by the lateral lenticulostriate artery. His hemiparesis improved gradually, and by post-trauma day 10 he was able to walk briefly without assistance. He was discharged on foot at post-trauma day 14.


CONCLUSIONS
Children with minor head trauma who have normal findings on initial CT scan may rarely have basal ganglionic infarction resulting from arterial spasm or thromboembolism of the perforating arteries. Hospital admission and careful observation should be considered for patients with minor head injury and persistent neurologic deficits despite normal CT findings. Magnetic resonance study is valuable for the evaluation of posttraumatic infarction, differentiating from hemorrhagic diffuse axonal injuries.
Ahn
Jung Yong
JY
Department of Neurosurgery, Pochon CHA Medical University, Sungnam, South Korea. jyahn@cha.ac.kr
Han
In Bo
IB
Chung
Young Sun
YS
Yoon
Pyeong Ho
PH
Kim
Sang Heum
SH
D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications* / Q000473:pathology; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000209:etiology* / Q000473:pathology; D018810:Magnetic Resonance Angiography / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D014057:Tomography, X-Ray Computed / Q000379:methods