title: Basal ganglia stroke due to mild head trauma in pediatric age - clinical and therapeutic management: a case report and 10 year literature review.
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.
authors.affiliation: Department of Neurosurgical Sciences, University of Rome "Sapienza", Italy. link55@libero.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Landi
authors.forename: Nicola
authors.initials: N
authors.lastname: Marotta
authors.forename: Cristina
authors.initials: C
authors.lastname: Mancarella
authors.forename: Daniele
authors.initials: D
authors.lastname: Marruzzo
authors.forename: Maurizio
authors.initials: M
authors.lastname: Salvati
authors.forename: Roberto
authors.initials: R
authors.lastname: Delfini
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage; D001479:Basal Ganglia / Q000098:blood supply*; D002533:Cerebral Angiography; D006259:Craniocerebral Trauma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003937:Diagnosis, Differential; D004234:Diuretics, Osmotic / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D015599:Trauma Severity Indices
chemical_list: D000925:Anticoagulants; D004234:Diuretics, Osmotic