Sobani Zain A, Ali Arshad
Department of Neurosurgery, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan.
Surg Neurol Int. 2011;2:51. doi: 10.4103/2152-7806.80116. Epub 2011 Apr 28.
Studies have shown that nearly 3% of closed head injuries result in basal ganglia hemorrhages and that this may be a more frequent occurrence in pediatric patients. Various mechanisms based on shearing forces have been implicated in the injury; however, the underlying mechanism leading to the increased incidence in pediatric patients has not been well described. Angiographic data suggest that putamenal perforators in children are more severely stretched at acute angles compared to those in adults, which may be a contributing factor to the increased incidence.
We discuss a series of five relatively benign cases of traumatic putamenal strokes in children and review their presentations, mechanism of injury, neurological deficits, and management with reference to available literature.
Although generally an alarming situation, benign presentations of putamenal strokes may be seen in pediatric populations after closed head injuries. In such cases, conservative management with subsequent rehabilitation and physical therapy is recommended.
研究表明,近3%的闭合性颅脑损伤会导致基底节出血,且这种情况在儿科患者中可能更为常见。基于剪切力的各种机制与损伤有关;然而,导致儿科患者发病率增加的潜在机制尚未得到充分描述。血管造影数据表明,与成人相比,儿童壳核穿支动脉以锐角更严重地拉伸,这可能是发病率增加的一个促成因素。
我们讨论了一系列五例相对良性的儿童创伤性壳核卒中病例,并参照现有文献回顾了它们的表现、损伤机制、神经功能缺损及治疗方法。
尽管通常是令人担忧的情况,但闭合性颅脑损伤后的儿科人群中可能会出现壳核卒中的良性表现。在这种情况下,建议采取保守治疗并随后进行康复和物理治疗。