RESUMEN
Basal ganglia infarction in young children, mostly after mild head trauma, has been repeatedly reported. The pathogenesis and the risk factors are not fully understood. Lenticulostriate vasculopathy, usually referred to as basal ganglia calcification, is discussed as one of them. We describe five young (7-13 months old on presentation) male children who suffered from hemiparesis due to ischemic stroke of the basal ganglia, four of them after minor head trauma. All of them had calcification in the basal ganglia visible on computed tomography or cranial ultrasound but not on magnetic resonance imaging. Follow-up care was remarkable for recurrent infarction in three patients. One patient had a second symptomatic stroke on the contralateral side, and two patients showed new asymptomatic infarctions in the contralateral basal ganglia on imaging. In view of the scant literature, this clinic-radiologic entity seems under recognized. We review the published cases and hypothesize that male sex and iron deficiency anemia are risk factors for basal ganglia stroke after minor trauma in the context of basal ganglia calcification in infants. We suggest to perform appropriate targeted neuroimaging in case of infantile basal ganglia stroke, and to consider prophylactic medical treatment, although its value in this context is not proven.
Asunto(s)
Enfermedad Cerebrovascular de los Ganglios Basales/complicaciones , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/etiología , Traumatismos Craneocerebrales/complicaciones , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/etiología , Ganglios Basales/diagnóstico por imagen , Enfermedad Cerebrovascular de los Ganglios Basales/diagnóstico por imagen , Enfermedad Cerebrovascular de los Ganglios Basales/terapia , Isquemia Encefálica/terapia , Traumatismos Craneocerebrales/diagnóstico por imagen , Traumatismos Craneocerebrales/terapia , Diagnóstico Diferencial , Humanos , Lactante , Masculino , Paresia/diagnóstico por imagen , Paresia/etiología , Paresia/terapia , Estudios Retrospectivos , Accidente Cerebrovascular/terapiaRESUMEN
We aimed to investigate the role of pre-, peri- and neonatal risk factors in the development of autism spectrum disorder (ASD) among Armenian children with the goal of detecting and addressing modifiable risk factors to reduce ASD incidence. For this purpose a retrospective case-control study using a random proportional sample of Armenian children with ASD to assess associations between various factors and ASD was conducted. The study was approved by the local ethical committee, and parental written consent was obtained. A total of 168 children with ASD and 329 controls were included in the analysis. Multivariable logistic regression analysis revealed that male gender, maternal weight gain, use of MgB6, self-reported stress during the pregnancy, pregnancy with complications, as well as use of labor-inducing drugs were associated with a significant increase in the odds of ASD, whereas Duphaston use during pregnancy, the longer interpregnancy interval and birth height were associated with decreased odds of ASD. These findings are pertinent as many identified factors may be preventable or modifiable, underscoring the importance of timely and appropriate public health strategies aimed at disease prevention in pregnant women to reduce ASD incidence.