Basal Ganglia Stroke after Mild Traumatic Brain Injury in Mineralizing Lenticulostriate Vasculopathy

 

 Buy Article Permissions and Reprints

Abstract

Although the association between basal ganglia (BG) stroke and mild traumatic brain injury (TBI) is well recognized, its association with lenticulostriate vasculopathy has only recently been described. We present the case of a 6-month-old female infant without personal or familiar relevant records who presented with left-sided hemiparesis and without altered consciousness after a mild TBI. An emergency computed tomography (CT) scan of the brain revealed bilateral linear calcifications along the course of the lenticulostriate arteries. Brain magnetic resonance imaging (MRI) revealed an ischemic lesion in the right BG and damage to the posterior limb of the right internal capsule. A few months after the ischemic event, the patient was asymptomatic. Given the clinical, radiological, and evolutionary characteristics of this group of patients, the term mineralizing angiopathy is proposed to define a specific clinical-imaging syndrome in infants who suffer a BG stroke after a mild TBI and present with the calcification of the lenticulostriate arteries.

Publication History

Received: 07 November 2022

Accepted: 29 December 2022

Article published online:
30 January 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

• References

• 1 Goraya JS, Berry S, Saggar K, Ahluwalia A. Stroke after minor head trauma in infants and young children with basal ganglia calcification: a lenticulostriate vasculopathy?. J Child Neurol 2018; 33 (02) 146-152
  CrossrefPubMedGoogle Scholar
• 2 Lingappa L, Varma RD, Siddaiahgari S, Konanki R. Mineralizing angiopathy with infantile basal ganglia stroke after minor trauma. Dev Med Child Neurol 2014; 56 (01) 78-84
  CrossrefPubMedGoogle Scholar
• 3 Yang FH, Wang H, Zhang JM, Liang HY. Clinical features and risk factors of cerebral infarction after mild head trauma under 18 months of age. Pediatr Neurol 2013; 48 (03) 220-226
  CrossrefPubMedGoogle Scholar
• 4 deVeber GA, Kirton A, Booth FA. et al. Epidemiology and outcomes of arterial ischemic stroke in children: the Canadian Pediatric Ischemic Stroke Registry. Pediatr Neurol 2017; 69: 58-70
  CrossrefPubMedGoogle Scholar
• 5 Mackay MT, Wiznitzer M, Benedict SL, Lee KJ, Deveber GA, Ganesan V. International Pediatric Stroke Study Group. Arterial ischemic stroke risk factors: the International Pediatric Stroke Study. Ann Neurol 2011; 69 (01) 130-140
  CrossrefPubMedGoogle Scholar
• 6 Deveber G. Stroke in infancy: a convergence of causes. Dev Med Child Neurol 2014; 56 (01) 9-10
  CrossrefPubMedGoogle Scholar
• 7 Gowda VK, Manjeri V, Srinivasan VM, Sajjan SV, Benakappa A. Mineralizing angiopathy with basal ganglia stroke after minor trauma: case series including two familial cases. J Pediatr Neurosci 2018; 13 (04) 448-454
  CrossrefPubMedGoogle Scholar
• 8 Shaffer L, Rich PM, Pohl KR, Ganesan V. Can mild head injury cause ischaemic stroke?. Arch Dis Child 2003; 88 (03) 267-269
  CrossrefPubMedGoogle Scholar
• 9 Baby N, Vinayan KP, Roy AG. Mineralizing angiopathy of lenticulostriate arteries with infantile basal ganglia infarct following minor head trauma: a case series. Ann Indian Acad Neurol 2019; 22 (03) 316-319
  CrossrefPubMedGoogle Scholar
• 10 Buompadre MC, Arroyo HA. Stroke Group. Basal ganglia and internal capsule stroke in childhood–risk factors, neuroimaging, and outcome in a series of 28 patients: a tertiary hospital experience. J Child Neurol 2009; 24 (06) 685-691
  CrossrefPubMedGoogle Scholar
• 11 Teele RL, Hernanz-Schulman M, Sotrel A. Echogenic vasculature in the basal ganglia of neonates: a sonographic sign of vasculopathy. Radiology 1988; 169 (02) 423-427
  CrossrefPubMedGoogle Scholar
• 12 Sisman J, Rosenfeld CR. Lenticulostriate vasculopathy in neonates: is it a marker of cerebral insult? Critical review of the literature. Early Hum Dev 2015; 91 (07) 423-426
  CrossrefPubMedGoogle Scholar
• 13 Cantey JB, Sisman J. The etiology of lenticulostriate vasculopathy and the role of congenital infections. Early Hum Dev 2015; 91 (07) 427-430
  CrossrefPubMedGoogle Scholar
• 14 Kieslich M, Fiedler A, Heller C, Kreuz W, Jacobi G. 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 (01) 13-16
  CrossrefPubMedGoogle Scholar
• 15 Squier W, Mack J. Mineralizing angiopathy and minor head trauma. Dev Med Child Neurol 2014; 56 (07) 699
  CrossrefPubMedGoogle Scholar