Clinical features and prognosis analysis of posttraumatic infarction in the basal ganglia in children

Objective To explore the clinical and imaging features of posttraumatic infarction in the basal ganglia in children for improving the level of diagnosis and treatment. Methods The clinical and imaging data of 19 cases of posttraumatic infarction in the basal ganglia in our department between August, 2010 and August, 2015 were retrospectively analyzed and the follow-up was carried to evaluate the outcome. Results Among the patients, 11 were male and 8 were female. The onset age ranged from 6 months to 5 years, and 15 cases (78. 9%) were under 3 years. All patients had preceding mild head trauma. Eight cases (42. 1%) fell from bed and 6 cases (31. 6%) tumbled. Three patients (10. 5%) were hit and 2 patients were crashed. Hemiplegia occurred in all the patients. It happened in 24 hours after trauma in 7 cases (36. 8%), 24 to 48 hours in 8 cases (42. 1%), and 48 hours to 7 days in 4 cases (21. 1%). Eleven cases showed left hemiplegia and 8 cases presented right hemiplegia. Strength ranged from 0 to 2 level in 7 cases, and 2 + To 4 level in 12 cases. The accompanying symptoms involved restlessness in 7 cases, vomiting in 5 cases, alalia in 4 cases, and convulsion in 2 cases. The cranial MRI in all patients showed long T1 and long T2 signal, Fl AIR high signal, DWI obviously high signal in the basal ganglia. There were no placeholder effects. All the patients got the medicine treatment and rehabilitation training. Ten patients were hospitalized for 2 weeks and 9 for 3 weeks. Eleven patients presented normal strength when leaving hospital. Seventeen patients were followed up for 6 months to 5 years who showed normal in nervous system examination. Thirteen cases under the age of 6 years showed critical to normal by Gesell development evaluation. Conclusion Posttraumatic infarction in the basal ganglia mainly occurs in infants and young children. The cause of the head injury is usually mild. Hemiplegia is the primary symptom and the strength varies obviously. Cranial MRI plays an important role in the early identification of the lesions. Most patients have favorable prognosis with the early diagnosis and treatment.