Injuries of Basal Ganglia following Head Trauma in Children

Abstract

7 pediatric patients with injuries of basal ganglia following head trauma were reported. They ranged in age from 10 months to 10 years. 5 boys and 2 girls comprised the patients. Cases 1–4 are mild cases in which the children fell down backward while playing, followed by a minimum loss of consciousness. In every case there was hemiparesis, but all of them showed remarkable recovery. CT findings are that of unilateral basal ganglia infarction. In cases 5–7, patients suffered from symptoms of brain contusion after running out in front of an oncoming car, and they developed hemiparesis. CT findings in cases 5 and 6 showed unilateral infarction. CT of case 7 showed a massive unilateral hemorrhage of the basal ganglia. All 7 cases sustained only slight scalp wounds and no skull fracture in spite of the severity of injuries signs and CT findings. This discrepancy seems to be explained only by the so-called shearing strain theory. But we have hypothesized that anterior stretch of the lateral branch of the perforator of the middle cerebral artery plays a major role in its pathogenesis.

Reversible parkinsonism and dystonia following probable mycoplasma pneumoniae infection

“…The etiology of isolated torticollis remains unknown in most of the cases. Our patients, along with previously reported cases with symptomatic torticollis (19)(20)(21)(22), illustrates that this symptom can be caused by striatal lesions.…”

Symptomatic Dystonias Associated with Structural Brain Lesions: Report of 16 Cases

“…In all 3 patients with segmental dysotnia, complete signs had developed in a course of 2-3 months, beginning as torticollis in 2 of them. Isolated cervical dystonia has been reported in association with an A-V malformation involving the caudate nucleus contralateral to the direction of neck rotation (as in our Patient 16), 4 with lacunar infarctions in the contralateral putamen, 21 with traumatic infarction in the contralateral caudate nucleus and putamen, 22,23 with a midbrain lesion in a case of multiple sclerosis, 24 and with a unilateral lesion in the centrum semiovale. 25 The significance of basal ganglia injuries in secondary cervical dystonia has had recent support by the finding of prolonged MRI T 2 times exclusively in the lentiform nucleus in idiopathic spasmodic torticollis.…”

Pontine Infarction Induced by Injury of the Perforating Branch of the Basilar Artery After Blunt Head Impact -Case Report-

“…Brain infarction following perforator injury, which also tends to occur following shearing force due to blunt head trauma, is thus more frequently reported in children 1,6,8,14) than in adults. 23) Furthermore, the cerebral hemisphere may be more vulnerable than the brainstem following shearing force, 17) as infarction of the basal ganglia due to perforator injury induced by shear stress 1,6,8,14) is more frequent than that of the brainstem 21) in children. Again, infarction due to perforator injury induced by shear stress of both basal ganglia and brainstem is extremely rare in adults in comparison to children.…”