Basal Ganglia Stroke in Children Following a History of Fall: A Study of Five Cases with Mineralizing Angiopathy

Aims and background: Arterial ischemic stroke is a significant cause of stroke in pediatric patients.Trauma-induced endothelial injury and fibrin accumulation can cause ischemia of cerebral parenchyma, resulting in a distinct clinico-radiological entity.Basal ganglia stroke is often associated with mineralization of lenticulostriate arteries.Materials and methods: A retrospective analysis was conducted on consecutive children with basal ganglia stroke and mineralization of lenticulostriate arteries from a tertiary care center in South India.The study group was formed by children with mineralization in the distribution of the lenticulostriate arteries and basal ganglia infarcts.Their demographic data, clinical and radiological characteristics, treatment response, neurodevelopmental outcome, and recurrence of stroke were noted.Results: Among all the children who suffered arterial ischemic strokes during the study period, only five infants with basal ganglia ischemic stroke and mineralization of the lenticulostriate arteries were included.All five cases had a history of fall or trauma.The study group was formed by children before 24 months of age, and the majority had hemiparesis.The follow-up period was brief, but all patients showed a partial or complete recovery.Conclusion: Basal ganglia stroke in children with a history of falls may be caused by mineralizing angiopathy.Early detection and timely management of risk factors may prevent recurrence and improve neurodevelopmental outcomes.Clinical significance: Basal ganglia stroke in infants following trauma is a distinct clinico-radiological entity.Early detection of the lenticulostriate arteries can be detected on radiological investigations, and timely treatment with aspirin and cilostazol can lead to partial to complete recovery.