Pediatric traumatic putamenal strokes: Mechanisms and prognosis

BACKGROUND: Studies have shown that nearly 3% of closed head injuries result in basal ganglia hemorrhages and that this may be a more frequent occurrence in pediatric patients. Various mechanisms based on shearing forces have been implicated in the injury; however, the underlying mechanism leading to the increased incidence in pediatric patients has not been well described. Angiographic data suggest that putamenal perforators in children are more severely stretched at acute angles compared to those in adults, which may be a contributing factor to the increased incidence. CASE DESCRIPTION: We discuss a series of five relatively benign cases of traumatic putamenal strokes in children and review their presentations, mechanism of injury, neurological deficits, and management with reference to available literature. CONCLUSION: Although generally an alarming situation, benign presentations of putamenal strokes may be seen in pediatric populations after closed head injuries. In such cases, conservative management with subsequent rehabilitation and physical therapy is recommended.