A previously healthy 18-month-old boy presents to the emerg | Figure 1

DrCherilynCecchini

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Pediatrics

A previously healthy 18-month-old boy presents to the emergency department after a fall. Parents report that father was carrying the child down the stairs when he slipped 2 steps from the bottom; the child fell out of his arms and landed on his chest on the hardwood floor. The child did not lose consciousness and he cried immediately, but several minutes later, his mother noticed that he seemed “dazed.” He was observed in the ED.

After a trial of oral intake, he stood up to walk, at which point he was noted to be slightly antalgic. Mother noticed right-sided facial droop when he smiled and that his head was tilted to the left. The physician noted decreased movement of the right arm and leg, with only a weak grip in his right hand. The head CT revealed the diagnosis. Basal ganglia stroke after minor trauma associated with mineralizing angiopathy is an uncommon phenomenon in children, but it is a unique clinicoradiological entity (pictured here).

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