Abstract Objective To investigate the clinical characteristics and prognosis of infants and young children with basal ganglia infarction after minor head trauma (BGIMHT). Methods A retrospective analysis was conducted on the clinical data and follow-up results of children aged 28 days to 3 years with BGIMHT who were hospitalized at Children's Hospital of Soochow University from January 2011 to January 2022. Results A total of 45 cases of BGIMHT were included, with the most common symptom being limb movement disorders (96%, 43/45), followed by facioplegia (56%, 25/45). Cerebral imaging showed that 72% (31/43) had infarction accompanied by basal ganglia calcification. After conservative treatment, 42 children (93%) showed significant symptom improvement, while 3 children (7%) experienced recurrent strokes. The median follow-up time was 82 months (range: 17-141 months). At the last follow-up, 97% (29/30) had residual basal ganglia softening lesions. Among 29 cases participating in questionnaire follow-up, 66% (19/29) recovered normally, 17% (5/29) showed significant improvement in symptoms, and 17% (5/29) had poor improvement. According to the grading of the Global Burden of Disease Control Projects, only 1 child (3%) had severe sequelae. There were no significant differences in age at onset, gender, or presence of concomitant basal ganglia calcification between children with and without neurological sequelae (P>0.05). Conclusions The most common initial symptom of BGIMHT is limb movement disorder, and imaging results indicate that most children have concurrent intracranial calcifications. Most infarct lesions later transform into softening lesions, resulting in a generally good prognosis.
XU Huan,WU Chen-Chen,TANG Ji-Hong et al. Clinical characteristics and long-term follow-up study of basal ganglia infarction after minor head trauma in infants and young children[J]. CJCP, 2025, 27(1): 68-74.
XU Huan,WU Chen-Chen,TANG Ji-Hong et al. Clinical characteristics and long-term follow-up study of basal ganglia infarction after minor head trauma in infants and young children[J]. CJCP, 2025, 27(1): 68-74.
Krishnamurthi RV, deVeber G, Feigin VL, et al. Stroke prevalence, mortality and disability-adjusted life years in children and youth aged 0-19 years: data from the global and regional burden of stroke 2013[J]. Neuroepidemiology, 2015, 45(3): 177-189. PMID: 26505982. DOI: 10.1159/000441087.
Yang FH, Wang H, Zhang JM, et al. Clinical features and risk factors of cerebral infarction after mild head trauma under 18 months of age[J]. Pediatr Neurol, 2013, 48(3): 220-226. PMID: 23419473. DOI: 10.1016/j.pediatrneurol.2012.12.008.
Wang G, Luan Y, Feng L, et al. Current status of infarction in the basal ganglia-internal capsule due to mild head injury in children using PRISMA guidelines[J]. Exp Ther Med, 2020, 19(2): 1149-1154. PMID: 32010282. PMCID: PMC6966180. DOI: 10.3892/etm.2019.8320.
Wang G, Liang J, Xin C, et al. Association of Cytomegalovirus infection with lenticulostriate stroke after mild head trauma in young children[J]. J Child Neurol, 2022, 37(12/14): 922-926. PMID: 35118892. DOI: 10.1177/08830738221077756.
Jiang W, Fu J, Chen F, et al. Basal ganglia infarction after mild head trauma in pediatric patients with basal ganglia calcification[J]. Clin Neurol Neurosurg, 2020, 192: 105706. PMID: 32058199. DOI: 10.1016/j.clineuro.2020.105706.
Bahri R, Sharma RS, Jain V. Mineralizing angiopathy with basal ganglia stroke after minor head trauma; a clinical profile and follow up study of a large series of paediatric patients from North India[J]. Eur J Paediatr Neurol, 2021, 33: 61-67. PMID: 34077857. DOI: 10.1016/j.ejpn.2021.05.011.
Edmond K, Clark A, Korczak VS, et al. Global and regional risk of disabling sequelae from bacterial meningitis: a systematic review and meta-analysis[J]. Lancet Infect Dis, 2010, 10(5): 317-328. PMID: 20417414. DOI: 10.1016/S1473-3099(10)70048-7.
Lingappa L, Varma RD, Siddaiahgari S, et al. Mineralizing angiopathy with infantile basal ganglia stroke after minor trauma[J]. Dev Med Child Neurol, 2014, 56(1): 78-84. PMID: 24102209. DOI: 10.1111/dmcn.12275.
Gorodetsky C, Pulcine E, Krishnan P, et al. Childhood arterial ischemic stroke due to mineralizing angiopathy: an 18-year single-center experience[J]. Dev Med Child Neurol, 2021, 63(9): 1123-1126. PMID: 33959946. DOI: 10.1111/dmcn.14903.
Baby N, Vinayan KP, Roy AG. Mineralizing angiopathy of lenticulostriate arteries with infantile basal ganglia infarct following minor head trauma: a case series[J]. Ann Indian Acad Neurol, 2019, 22(3): 316-319. PMID: 31359945. PMCID: PMC6613412. DOI: 10.4103/aian.AIAN_444_18.
Li T, Ma J, Hong S, et al. Childhood ischaemic stroke in the basal ganglia can lead to fine motor and anxiety disorders: a retrospective analysis and follow-up of 109 cases[J]. BMC Neurol, 2021, 21(1): 84. PMID: 33610173. PMCID: PMC7896398. DOI: 10.1186/s12883-021-02112-z.
Balcerzyk A, Niemiec P, Kopyta I, et al. Methylenetetrahydrofolate reductase gene A1298C polymorphism in pediatric stroke: case-control and family-based study[J]. J Stroke Cerebrovasc Dis, 2015, 24(1): 61-65. PMID: 25440348. DOI: 10.1016/j.jstrokecerebrovasdis.2014.07.034.
