Post-traumatic cerebral infarction: a rare complication in a pediatric patient after mild head injury

Because the cases of post-traumatic cerebral infarction in children are uncommon, little research has been done on this subject. The case of a 14-month-old child who had cerebral infarction after mild head injury is discussed. He fell from a height of approximately 70 cm 12 hours before. He did not use his left arm after the injury. His parents took him to the public hospital, where he was investigated in terms of mechanical complication and was observed for six hours, but no computed tomography (CT) scan was performed at that time. The patient was then presented to our department by his parents. He was not able to walk and was sitting. His neurological examination revealed right hemihypoesthesia, hemiparesis and mild left facial paresis. CT showed a hypodense region in the right basal ganglia location. The right lateral ventricle seemed mildly compressed due to edematous changes. The magnetic resonance imaging revealed hyperintense signal changes that affected the right lentiform nucleus and the head of the caudate nucleus. The aim of the case is to remind emergency physicians that post-traumatic ischemic stroke is uncommon but may be
the cause of disability in pediatric patients, and a systematic physical examination must be performed in all ages even if the patients appear quite well.

Posttravmatik serebral iskemi: Pediyatrik yaþ grubunda minör kafa travmasý sonrasý geliþen nadir bir komplikasyon

Çocukluk çaðýnda travma sonrasý görülen serebral iskemi oldukça nadirdir. Bu konuda çok az çalýþma yapýlmýþtýr. Burada minör kafa travmasý sonrasý, 14 aylýk pediyatrik
bir hastada görülen serebral iskemi olgusu sunuldu. 14 aylýk bir çocuk 12 saat önce 70 santimetre yükseklikten düþme sonrasý sað kolunu kullanamama þikayetiyle acil servise
getirildi. Hastanýn daha önce gittiði hastanede minör kafa travmasý olarak izlendiði ve kraniyal görüntülemenin yapýlmadýðý öðrenildi. Hastanýn kolunu kullanamamasý mekanik
bir komplikasyon olarak görülmüþ ve bu monoparazi olarak deðerlendirilmemiþti. Hasta baþvurduðu sýrada yürüyemediði ve oturamadýðý da belirlendi. Minör kafa travmalý
hastada baþka bir travma izine rastlanmadý. Yapýlan nörolojik muayenesinde hafif bir sað hemiparazi ve sol fasiyal paralizi saptandý. Çekilen beyin tomografisinde sað bazal
ganglionlar seviyesinde hipodens görüntü tespit edilen hastanýn MRG’sinde sað lentiform ve caudat nukleuslarý sevisinde enfarktüs saptandý. Bu yazýnýn amacý, acil servis hekimlerine pediyatrik yaþ grubunda nadir görülmesine raðmen kalýcý sakatlýklara yol açabilen posttravmatik serebral iskemiyi ve hangi yaþ grubunda olursa olsun ve hasta ne
kadar iyi görünürse görünsün sistemik fiziksel incelemenin tüm hastalara uygulanmasý gerektiðini hatýrlatmaktýr.