Clinical characteristics and long-term follow-up study of basal ganglia infarction after minor head trauma in infants and young children
徐欢 1吴晨晨 1汤继宏 1冯隽 1肖潇 1师晓燕 1梅道启1
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作者信息
1. 苏州大学附属儿童医院神经内科,江苏 苏州 215025
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摘要
目的 探讨婴幼儿轻度脑外伤后基底节梗死(basal ganglia infarction after minor head trauma,BGIMHT)的临床特点及预后.方法 回顾性分析2011年1月—2022年1月在苏州大学附属儿童医院住院的28 d至3岁BGIMHT患儿的临床资料和随访结果.结果 纳入的45例BGIMHT患儿中,最常见症状为肢体活动障碍(96%,43/45),其次为面瘫(56%,25/45),头颅影像学见梗死伴基底节钙化占72%(31/43).经保守治疗后,42例(93%)患儿症状改善,3例(7%)出现卒中反复.中位随访时间82(范围:17～141)个月,截至末次随访,97%(29/30)残留基底节软化灶;29例参与问卷随访,复发和康复问卷评估示66%(19/29)患儿恢复正常,17%(5/29)症状明显改善,17%(5/29)改善欠佳;全球疾病负担重点控制项目分级量表评估示仅1例(3%)残存严重后遗症.无神经系统后遗症患儿及有神经系统后遗症患儿的起病年龄、性别及有无合并BGC比较差异无统计学意义(P>0.05).结论 BGIMHT最常见首发症状为肢体活动障碍,影像学结果见大部分患儿同时存在颅内钙化灶,多数梗死灶后期转化为软化灶,总体预后良好.
Abstract
Objective To investigate the clinical characteristics and prognosis of infants and young children with basal ganglia infarction after minor head trauma(BGIMHT).Methods A retrospective analysis was conducted on the clinical data and follow-up results of children aged 28 days to 3 years with BGIMHT who were hospitalized at Children's Hospital of Soochow University from January 2011 to January 2022.Results A total of 45 cases of BGIMHT were included,with the most common symptom being limb movement disorders(96%,43/45),followed by facioplegia(56%,25/45).Cerebral imaging showed that 72%(31/43)had infarction accompanied by basal ganglia calcification.After conservative treatment,42 children(93%)showed significant symptom improvement,while 3 children(7%)experienced recurrent strokes.The median follow-up time was 82 months(range:17-141 months).At the last follow-up,97%(29/30)had residual basal ganglia softening lesions.Among 29 cases participating in questionnaire follow-up,66%(19/29)recovered normally,17%(5/29)showed significant improvement in symptoms,and 17%(5/29)had poor improvement.According to the grading of the Global Burden of Disease Control Projects,only 1 child(3%)had severe sequelae.There were no significant differences in age at onset,gender,or presence of concomitant basal ganglia calcification between children with and without neurological sequelae(P>0.05).Conclusions The most common initial symptom of BGIMHT is limb movement disorder,and imaging results indicate that most children have concurrent intracranial calcifications.Most infarct lesions later transform into softening lesions,resulting in a generally good prognosis.
关键词
脑外伤/基底节梗死/临床特点/随访/婴幼儿
Key words
Head trauma/Basal ganglia infarction/Clinical characteristic/Follow-up/Infant and young child
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