Clinical characteristics and long-term follow-up study of basal ganglia infarction after minor head trauma in infants and young children

XU Huan; WU Chen-Chen; TANG Ji-Hong; FENG Jun; XIAO Xiao; SHI Xiao-Yan; MEI Dao-Qi

doi:10.7499/j.issn.1008-8830.2408136

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Chinese Journal of Contemporary Pediatrics ›› 2025, Vol. 27 ›› Issue (1) : 68-74. DOI: 10.7499/j.issn.1008-8830.2408136

CLINICAL RESEARCH

Clinical characteristics and long-term follow-up study of basal ganglia infarction after minor head trauma in infants and young children

XU Huan, WU Chen-Chen, TANG Ji-Hong, FENG Jun, XIAO Xiao, SHI Xiao-Yan, MEI Dao-Qi

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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.

Key words

Head trauma / Basal ganglia infarction / Clinical characteristic / Follow-up / Infant and young child

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XU Huan, WU Chen-Chen, TANG Ji-Hong, FENG Jun, XIAO Xiao, SHI Xiao-Yan, MEI Dao-Qi. Clinical characteristics and long-term follow-up study of basal ganglia infarction after minor head trauma in infants and young children[J]. Chinese Journal of Contemporary Pediatrics. 2025, 27(1): 68-74 https://doi.org/10.7499/j.issn.1008-8830.2408136

References

1 Mallick AA, O'Callaghan FJ. The epidemiology of childhood stroke[J]. Eur J Paediatr Neurol, 2010, 14(3): 197-205. PMID: 19879783. DOI: 10.1016/j.ejpn.2009.09.006.
2 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.
3 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.
4 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.
5 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.
6 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.
7 刘爱民. 国际疾病分类第九版临床修订本手术与操作: ICD-9-CM-3（2008 版）[M]. 北京: 人民军医出版社, 2008.
8 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.
9 Lo WD, Ichord RN, Dowling MM, et al. The Pediatric Stroke Recurrence and Recovery Questionnaire: validation in a prospective cohort[J]. Neurology, 2012, 79(9): 864-870. PMID: 22895580. PMCID: PMC3425845. DOI: 10.1212/WNL.0b013e318266fc9a.
10 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.
11 Fox CK, Sidney S, Fullerton HJ. Community-based case-control study of childhood stroke risk associated with congenital heart disease[J]. Stroke, 2015, 46(2): 336-340. PMID: 25516197. PMCID: PMC4308424. DOI: 10.1161/STROKEAHA.114.007218.
12 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.
13 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.
14 Chung MG, Guilliams KP, Wilson JL, et al. Arterial ischemic stroke secondary to cardiac disease in neonates and children[J]. Pediatr Neurol, 2019, 100: 35-41. PMID: 31371125. PMCID: PMC7034952. DOI: 10.1016/j.pediatrneurol.2019.06.008.
15 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.
16 马秀伟, 辜蕊洁, 侯豫, 等. 儿童外伤后基底节区梗死的临床特征及预后分析[J]. 中华全科医学, 2017, 15(9): 1532-1535. DOI: 10.16766/j.cnki.issn.1674-4152.2017.09.025.
17 Badar SA, Radhakrishnan R, Golomb MR. The impact of pediatric basal ganglia stroke on mental health in children: report of 2 cases[J]. Child Neurol Open, 2020, 7: 2329048X20979248. PMID: 33403220. PMCID: PMC7745549. DOI: 10.1177/2329048X20979248.
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.
19 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.
20 Kanamori K, Sakaguchi Y, Tsuda K, et al. Refractory cerebral infarction in a child with an ACTA2 mutation[J]. Brain Dev, 2021, 43(4): 585-589. PMID: 33342581. DOI: 10.1016/j.braindev.2020.12.001.
21 张临霞, 杜丽君, 唐宇晖, 等. 儿童脑梗死60例临床特征和病因分析[J]. 中国药物与临床, 2019, 19(19): 3332-3334. DOI: 10.11655/zgywylc2019.19.030.
22 周吉华, 明美秀, 陈伟明, 等. 重症监护病房儿童脑卒中临床特征和功能结局分析[J]. 中华全科医学, 2023, 21(2): 180-185. DOI: 10.16766/j.cnki.issn.1674-4152.002840.
23 孙丹, 刘智胜, 金润铭, 等. 儿童缺血性脑卒中42例病因影像学特征及预后临床回顾分析[J]. 中国实用儿科杂志, 2014, 29(2): 141-145.