Brower M C, Rollins N, Roach E S
Division of Pediatric Neurology, University of Texas Southwestern Medical Center, Dallas, USA.
Arch Neurol. 1996 Dec;53(12):1252-6. doi: 10.1001/archneur.1996.00550120060017.
We present the signs, symptoms, and radiographic features of 36 children with ischemic infarctions of the basal ganglia, internal capsule, or thalamus.
The series includes 14 males and 22 females ranging in age from newborn to 13 years. Twenty-seven patients were evaluated with computed tomography, 34 with magnetic resonance imaging, 16 with magnetic resonance angiography, and 10 with conventional cerebral angiography. Thirty patients had unilateral lesions (16 left, 14 right) and 6 had bilateral infarctions.
The most common presenting symptom was hemiplegia (30 of 36). Other children presented with aphasia (5 of 36), seizures (5 of 36), altered consciousness (5 of 36), and hemisensory changes (5 of 36). Four of 6 patients with bilateral lesions presented with altered mental status, but the location of a unilateral infarction within the thalamus or basal ganglia did not predict the clinical presentation.
The risk factors for basal ganglia infarction in children are diverse, but systemic hypertension does not play a major role in children. The vascular occlusion often occurred in the large arteries, with secondary occlusion of the smaller penetrating arteries. Most children with a single unilateral infarction have a good prognosis.
我们展示了36例患有基底节、内囊或丘脑缺血性梗死患儿的体征、症状及影像学特征。
该系列包括14名男性和22名女性，年龄从新生儿到13岁。27例患者接受了计算机断层扫描评估，34例接受了磁共振成像评估，16例接受了磁共振血管造影评估，10例接受了传统脑血管造影评估。30例患者有单侧病变（16例左侧，14例右侧），6例有双侧梗死。
最常见的首发症状是偏瘫（36例中的30例）。其他患儿表现为失语（36例中的5例）、癫痫发作（36例中的5例）、意识改变（36例中的5例）和偏身感觉改变（36例中的5例）。6例双侧病变患者中有4例出现精神状态改变，但丘脑或基底节单侧梗死的部位并不能预测临床表现。
儿童基底节梗死的危险因素多种多样，但系统性高血压在儿童中不起主要作用。血管闭塞常发生在大动脉，继而较小的穿通动脉闭塞。大多数单侧梗死的儿童预后良好。
