Can mild head injury cause ischaemic stroke?

Five cases of ischaemic stroke preceded by minor head trauma in children are described. All patients had striatocapsular infarction. Three had no cerebrovascular abnormality; two had turbulent flow in the proximal middle cerebral artery. None of the patients had evidence of arterial dissection or any other risk factors for stroke. All made an excellent neurological recovery. Possible mechanisms include mechanical disruption to the flow in the perforating branches of the middle cerebral artery, intimal trauma and subsequent thrombosis, or arterial spasm induced by trauma. The specific susceptibility in affected children remains unexplained; both genetic and environmental factors (for example, previous chickenpox) may be implicated.