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Transient Cerebral Arteriopathy: A Disorder Recognized by Serial Angiograms in Children With Stroke
Stéphane Chabrier, MD
Service de Neurologie, Département de Pédiatrie
Georges Rodesch, MD
Service de Neuroradiologie Vasculaire Diagnostique et Interventionnelle, Hôpital de Bicêtre, Le Kremlin-Bicêtre Cedex, France
Pierre Lasjaunias, MD
Service de Neuroradiologie Vasculaire Diagnostique et Interventionnelle, Hôpital de Bicêtre, Le Kremlin-Bicêtre Cedex, France
Marc Tardieu, MD
Service de Neurologie, Département de Pédiatrie
Pierre Landrieu, MD
Service de Neurologie, Département de Pédiatrie
Guillaume Sébire, MD, PhD
Service de Neurologie, Département de Pédiatrie
Repeated clinical evaluation and cerebral arteriography during the evolution of ischemic strokes of idiopathic origin allowed us to characterize a transient cerebral arteriopathy. We retrospectively studied the clinical characteristics, course, and neuroimaging features of this disorder in nine children. Of 34 children with ischemic strokes seen consecutively between 1984 and 1995, 9 (26%) were diagnosed as having transient attack of the cerebral arterial wall, termed transient cerebral arteriopathy. All of these patients had previously been in good health. The mean age at the time of the first stroke was 6 years (range, 29/12 years to 134/12 years). All children presented with acute hemiplegia. A recurrence of the stroke took place 3 months at the latest after the initial infarct in three children (mean clinical follow-up 27/12 years). Cerebral imaging in all the patients showed small subcortical infarcts located in basal ganglia or internal capsule. Arteriography revealed multifocal lesions of the arterial wall (focal stenosis or segmental narrowing), mostly located in the initial parts of basal arteries of the carotid system. Longitudinal arteriographic follow-up showed initial worsening of these arterial lesions (n = 5) for a maximum duration of 7 months followed by complete regression (n = 2), improvement (n = 5), or stabilization of the lesions (n = 2). Five patients had a complete clinical recovery. Further studies are necessary to confirm a presumed inflammatory cause of this arteriopathy. (J Child Neurol 1998; 13:27-32).
Journal of Child Neurology, Vol. 13, No. 1,
27-32 (1998)
DOI: 10.1177/088307389801300105
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