基底节钙化的小儿患者轻度头部外伤后基底节梗死。
Basal ganglia infarction after mild head trauma in pediatric patients with basal ganglia calcification.
机构信息
Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, China.
Department of Radiology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, China.
出版信息
Clin Neurol Neurosurg. 2020 May;192:105706. doi: 10.1016/j.clineuro.2020.105706. Epub 2020 Jan 30.
OBJECTIVES
Incidence rate of basal ganglia infarction (BGI) after mild head trauma was reported higher in children with basal ganglia calcification (BGC). We would like to review patients with BGC showed in head CT scan to see the incidence rate of stroke in these patients and the correlation of variables in these cases.
PATIENTS AND METHODS
CT imaging data of cases with diagnosis of mild traumatic brain injury (mTBI) in a large tertiary pediatric center between Mar. 2014 and Mar. 2019 was retrospectively reviewed. Cases with findings of punctate calcification in the region of basal ganglion in CT scan were included. Correlation of variables of these cases (age, side and volume of basal ganglion calcification) with the diagnosis of BGI was the focus of this study.
RESULTS
37 patients (26 males, 9 females, median age: 3.88±3.54) were included in this study. 17 cases (45.9 %) were diagnosed of BGI and were admitted into the department of neurosurgery. Altogether 63 sides of BGC were categorized into two groups based on whether BGI happened and ROC curve was drawn. ROC curve showed when the cut-off point was 6.55 mm3, the sensitivity was 88.9 % and the specificity was 87.5 %; the area under curve was 0.849 (p<0.01). All the cases were divided into two groups according to whether basal ganglia infarction occurred or not. Mann-Whitney U test showed significant difference between these two groups in age (p=0.01). ROC curve of how age affect BGI after mTBI were drawn. The cut-off point was 3.25 years, and the sensitivity was 65.0 % and the specificity was 88.2 %; the area under curve was 0.746 (p=0.01). All patients received conservative treatment and recovered.
CONCLUSION
Incidence rate is higher in children with BGC after mild head injury than that of other children. Larger BGC volume indicates higher risk of developing infarction after minor head injury. Older children with BGC are less-likely getting BGI after mTBI.
目的
基底节区梗死（BGI）的发病率在伴有基底节钙化（BGC）的儿童轻度头部外伤后较高。我们希望回顾头部 CT 扫描显示 BGC 的患者，以观察这些患者中风的发生率以及这些病例中变量的相关性。
方法
回顾 2014 年 3 月至 2019 年 3 月期间在一家大型儿科三级中心诊断为轻度创伤性脑损伤（mTBI）的病例的 CT 成像数据。将 CT 扫描中基底节区点状钙化的病例纳入。本研究的重点是这些病例的变量（年龄、基底节钙化的侧位和体积）与 BGI 诊断的相关性。
结果
本研究共纳入 37 例患者（26 名男性，9 名女性，中位年龄：3.88±3.54）。17 例（45.9%）被诊断为 BGI 并被收入神经外科。根据是否发生 BGI，将 63 侧 BGC 分为两组，并绘制 ROC 曲线。ROC 曲线显示，当截断点为 6.55mm3 时，敏感性为 88.9%，特异性为 87.5%；曲线下面积为 0.849（p<0.01）。所有患者根据是否发生基底节梗死分为两组。Mann-Whitney U 检验显示两组年龄差异有统计学意义（p=0.01）。绘制了 mTBI 后年龄如何影响 BGI 的 ROC 曲线。截断点为 3.25 岁，敏感性为 65.0%，特异性为 88.2%；曲线下面积为 0.746（p=0.01）。所有患者均接受保守治疗并康复。
结论
轻度头部外伤后 BGC 患儿的发生率高于其他儿童。较大的 BGC 体积表明在轻微头部外伤后发生梗死的风险更高。伴有 BGC 的较大儿童在 mTBI 后发生 BGI 的可能性较小。
Zotero 插件