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- Title
Acute ischemic stroke secondary to childhood primary angiitis of cerebral nervous system (cPACNS) - case report and literature review.
- Authors
Karolina, Anuszkiewicz; Piotr, Stogowski; Marta, Zawadzka; Kinga, Ziołkowska; Ewa, Pasierbska; Maria, Mazurkiewicz-Bełdzińska
- Abstract
Introduction: Primary angiitis of central nervous system in childhood (cPACNS) is a rare idiopathic inflammatory disease and an increasing cause of acute ischemic stroke in children. Due to heterogenous classification and poorly understood pathomechanism there are no estimated prevalence and treatment guidelines for PACNS in pediatric population. Case report: A 6-year-old boy with symptoms of acute ischemic stroke was admitted. Neurological examination revealed left hemiparesis. After exclusion of brain hemorrhage the patient was primarily treated with anticoagulants. Brain magnetic resonance (MRI) showed reduced flow with longitudinal stenosis in right internal carotid artery and right middle cerebral artery. Numerous ischemic focuses acute and chronic were found in right cortical and subcortical regions. Hematologic disorders were excluded, as were other inflammatory disorders. Due to imaging studies and clinical features primary angiitis was suspected. Corticosteroids were administrated and regression of neurological deficits was observed. Eventually cPACNS was diagnosed. Conclusion: cPACNS should be considered after exclusion of systematic, rheumatological and secondary causes of vasculitis. Fast diagnosis and administration of therapy is absolutely essential as most of the case series carried on adult population suggest a favorable clinical outcome of cPACNS early treated with steroids.
- Subjects
ISCHEMIC stroke; NERVOUS system; HEMIPARESIS; HEMORRHAGE; CORTICOSTEROIDS
- Publication
Child Neurology / Neurologia Dziecięca, 2020, Vol 29, Issue 59, p88
- ISSN
1230-3690
- Publication type
Article
- DOI
10.20966/chn.2020.59.473