Falls leading to weakness or weakness leading to falls: an eternal dilemma
DOI:
https://doi.org/10.18203/2349-3291.ijcp20261558Keywords:
Mineralizing microangiopathy, Paediatric stroke, Vasculopathy, Stroke after minor traumaAbstract
Falls are common among children. A fall may be the consequence of an underlying stroke, or conversely, a fall itself may precipitate a stroke. Additionally, paediatric stroke can present with varied and nonspecific manifestations, making diagnosis challenging. Urgent diagnosis requires timely identification and starting of therapy, which makes recovery faster. Case 1: An 8-month-old male infant developed acute right-sided hemiparesis following trivial fall. MRI brain showed left lentiform nucleus acute infarct, and linear calcification on CT. Child was treated with aspirin, iron, and physiotherapy, with improvement over three months. Case 2: A 16-month-old boy presented with left-sided weakness after a fall. CT head showed linear hyperdensity in right caudate nucleus. Child was managed with aspirin and physiotherapy, with gradual recovery over six months. Aspirin therapy, along with physiotherapy and supportive treatment led to a good response in both the cases. Importance of considering mineralizing microangiopathy in paediatric patients with unexplained neurological symptoms following trauma is emphasized.
Metrics
References
Lingappa L, Varma RD, Siddaiahgari S, Konanki R. Mineralizing angiopathy with infantile basal ganglia stroke after minor trauma. Dev Med Child Neurol. 2014;56(1):78-84. DOI: https://doi.org/10.1111/dmcn.12275
Shaffer L, Rich PM, Pohl KRE, Ganesan V. Can mild head injury cause ischaemic stroke?. Arch Dis Child. 2003;88:267-9. DOI: https://doi.org/10.1136/adc.88.3.267
Deveber G. Stroke in infancy: a convergence of causes. Dev Med Child Neurol. 2014;56(1):9-10. DOI: https://doi.org/10.1111/dmcn.12296
Gorodetsky C, Pulcine E, Krishnan P, Singh J, Moharir M, MacGregor D, et al. Childhood arterial ischemic stroke due to mineralizing angiopathy: an 18-year single-center experience. Dev Med Child Neurol. 2021;63(9):1123-6. DOI: https://doi.org/10.1111/dmcn.14903
Goraya JS. Mineralizing Lenticulostriate Vasculopathy: An Emerging Risk Factor for Basal Ganglia Stroke After Minor Head Trauma in Young Children. Pediatr Neurol. 2023;145:22-7. DOI: https://doi.org/10.1016/j.pediatrneurol.2023.04.024
Laber EN, Laber DA. Association between iron deficiency anemia and thrombosis: a population-based study. Blood. 2023;142(1):5232. DOI: https://doi.org/10.1182/blood-2023-190934
Yang FH, Wang H, Jun-Mei Zhang JM, Liang HY. Clinical features and risk factors of cerebral infarction after mild head trauma under 18 months of age. Pediatr Neurol 2013;48:220-6. DOI: https://doi.org/10.1016/j.pediatrneurol.2012.12.008