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.

[1]  H. Arroyo,et al.  Basal Ganglia and Internal Capsule Stroke in Childhood—Risk Factors, Neuroimaging, and Outcome in a Series of 28 Patients: A Tertiary Hospital Experience , 2009, Journal of child neurology.

[2]  D Nast-Kolb,et al.  [Craniocerebral trauma]. , 2002, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.

[3]  A. Arboix,et al.  Clinical study of 222 patients with pure motor stroke , 2001, Journal of neurology, neurosurgery, and psychiatry.

[4]  L. Kramer,et al.  Acute neuroradiologic findings in young children with inflicted or noninflicted traumatic brain injury , 2000, Child's Nervous System.

[5]  L J Bagley,et al.  Imaging of neurological emergencies: trauma, hemorrhage, and infarction. , 1999, Seminars in roentgenology.

[6]  J. Bogousslavsky,et al.  Deep perforators from the carotid system. Template of the vascular territories. , 1990, Archives of neurology.

[7]  A Thron,et al.  The large striatocapsular infarct. A clinical and pathophysiological entity. , 1990, Archives of neurology.

[8]  M Dujovny,et al.  The perforating branches of the middle cerebral artery. A microanatomical study. , 1985, Journal of neurosurgery.

[9]  F. Umansky,et al.  Microsurgical anatomy of the recurrent artery of Heubner. , 1984, Journal of neurosurgery.

[10]  A. Rhoton,et al.  Microsurgical anatomy of the distal anterior cerebral artery. , 1978, Journal of neurosurgery.

[11]  A. Harris,et al.  Surgical anatomy of the proximal anterior cerebral artery. , 1976, Journal of neurosurgery.

[12]  M. Critchley THE ANTERIOR CEREBRAL ARTERY, AND ITS SYNDROMES , 1930 .