BASAL GANGLIA AND THALAMIC INFARCTION IN CHILDREN - CAUSE AND CLINICAL-FEATURES

Background: We present the signs, symptoms, and radiographic features of 36 children with ischemic infarctions of the basal ganglia, interna l capsule, or thalamus. Patients and Methods: The series includes 14 m ales and 22 females ranging in age from newborn to 13 years. Twenty-se ven patients were evaluated with computed tomography, 34 with magnetic resonance imaging, 16 with magnetic resonance angiography, and 10 wit h conventional cerebral angiography. Thirty patients had unilateral le sions (16 left, 14 right) and 6 had bilateral infarctions. Results: Th e most common presenting symptom was hemiplegia (30 of 36). Other chil dren presented with aphasia (5 of 36), seizures (5 of 36), altered con sciousness (5 of 36), and hemisensory changes (5 of 36). Four of 6 pat ients 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. Conclusions: The ri sk factors for basal ganglia infarction in children are diverse, but s ystemic hypertension does not play a major role in children. The vascu lar occlusion often occurred in the large arteries, with secondary occ lusion of the smaller penetrating arteries. Most children with a singl e unilateral infarction have a good prognosis.