CASE REPORT

Can mild head injury cause ischaemic stroke?

L Shaffer¹, P M Rich², K R E Pohl³, V Ganesan¹

¹ Neurosciences Unit, Institute of Child Health, University College, London WC1N 1EH, UK
² Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK
³ Department of Paediatric Neurology, Guys Hospital, London SE1 9RT, UK

Correspondence to:
Correspondence to:
Dr V Ganesan, Lecturer in Paediatric Neurology, The Wolfson Centre, Mecklenburgh Square, London WC1N 2AP, UK;
v.ganesan{at}ich.ucl.ac.uk

Five cases of ischaemic stroke preceded by minor head trauma in children are described. All patients had striatocapsular infarction. Three had no cerebrovascular abnormality; two had turbulent flow in the proximal middle cerebral artery. None of the patients had evidence of arterial dissection or any other risk factors for stroke. All made an excellent neurological recovery. Possible mechanisms include mechanical disruption to the flow in the perforating branches of the middle cerebral artery, intimal trauma and subsequent thrombosis, or arterial spasm induced by trauma. The specific susceptibility in affected children remains unexplained; both genetic and environmental factors (for example, previous chickenpox) may be implicated.

Keywords: stroke; trauma; head injury

Abbreviations: CT, computed tomography; MCA, middle cerebral artery; MRA, magnetic resonance angiography; MRI, magnetic resonance imaging

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This article has been cited by other articles:

• Buompadre, M. C., Arroyo, H. A., Stroke Group, (2009). Basal Ganglia and Internal Capsule Stroke in Childhood--Risk Factors, Neuroimaging, and Outcome in a Series of 28 Patients: A Tertiary Hospital Experience. J Child Neurol 24: 685-691 [Abstract]  
• Abend, N. S., Nance, M. L., Bonnemann, C. (2008). Subcutaneous Sumatriptan in an Adolescent With Acute Posttraumatic Headache. J Child Neurol 23: 438-440 [Abstract]  
• Bernard, T. J., deVeber, G. A., Benke, T. A. (2007). Athletic Participation After Acute Ischemic Childhood Stroke: A Survey of Pediatric Stroke Experts. J Child Neurol 22: 1050-1053 [Abstract]  
• Williams, A N (2003). Running around in circles following ischemic stroke. Arch. Dis. Child. 88: 743-743 [Full Text]  

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Running in circles following ischemic stroke

A.N. Williams

ADC Online, 5 Mar 2003 [Full text]