Pure Motor Stroke Secondary to Cerebral Infarction of Recurrent Artery of Heubner after Mild Head Trauma: A Case Report
BACKGROUND: The recurrent Heubner's artery is the distal part of the medial striate artery. Occlusion of the recurrent artery of Heubner, classically contralateral hemiparesis with fasciobrachiocrural predominance, is attributed to the occlusion of the recurrent artery of Heubner and is widely known as a stroke syndrome in adults. However, isolated occlusion of the deep perforating arteries following mild head trauma also occurs extremely rarely in childhood.
CASE REPORT: Here we report the case of an 11-year-old boy with pure motor stroke. The brain MRI showed an acute ischemia in the recurrent artery of Heubner supply area following mild head trauma. His fasciobrachial hemiparesis and dysarthria were thought to be secondary to the stretching of deep perforating arteries leading to occlusion of the recurrent artery of Heubner.CONCLUSION: Post-traumatic pure motor ischemic stroke can be secondary to stretching of the deep perforating arteries especially in childhood.
Plum Analytics Artifact Widget Block
Perlmutter D, Rhoton AL. Microsurgical anatomy of the distal anterior cerebral artery. Journal of Neurosurgery. 1978;49: 204-228.
Ghika JA, Bogousslavsky J, Regali F. Deep perforators from the carotid system: template of the vascular territories. Arch Neurol. 1990;47:1097â€“100.
Critchley M. The anterior cerebral artery and its syndromes. Brain1930; 53: 120-65.
Dunker PO, Harris AB. Surgical anatomy of the proximal anterior cerebral artery. Journal of Neurosurgery. 1976;44: 359-67.
Bagley LJ. Imaging of neurological emergencies: trauma, hemorrhage, and infarction. Semin Roentgenol. 1999;34:144-159.
Baumgartner J, Fletcher JM, Alpert B. Acute neuroradiologic findings in young children with inflicted or noninflicted traumatic brain injury. Childs Nerv Syst. 2000;16:25-33.
Weiller C, Ringelstein EB, Reiche W, Thron A, Buell U. The large striatocapsular infarct. A clinical and pathophysiological entity. Arch Neurol. 1990;47:1085-1091.
Buompadre MC, Arroyo HA, Stroke Group. Basal ganglia and internal capsule stroke in childhood- risk factors, neuroimaging and outcome in a series of 28 patients: A tertiary hospital experience. J Child Neurol. 2009;24:685-691.
Toole JF, Burrow DD. Pathophysiology and clinical evaluation of ischemic vascular disease. In: Youmans JR(ed), Neurological surgery. W.B. Saunders Company, Philadelphia, 1990: 1463-1515.
Arboix A, Padilla I, Massons J, Garcia-Eroles L, Comes E, Targa C. Clinic study of 222 patients with pure motor stroke. J Neurol Neurosurg Psychiatry. 2001;71(2): 239-42.
Gomes E, Dujovny M, Umansky F Ausman JI, Diaz FG, Ray WJ. Microsurgical anatomy of the recurrent artery of Heubner. Journal of Neurosurgery. 1984;60:130-9.
Umansky F, Gomez FB, Dujovny M, Diaz FG, Ausman JI, Mirchandani HG, Berman SK. The perforating branches of middle cerebral artery. A microsurgical study. Neurosurg. 1984;62:261-268.
Osborn AG. Craniocerebral trauma. In: Osborn AG [ed] Diagnostic euroradiology. Mosby, St. Louis,1994: 199-247.
All rights reserved.