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Acute hemiparesis in a child as a presenting symptom of hemispheric cerebral proliferative angiopathy

J J Gold1, J R Crawford

  • 1Division of Child Neurology, Department of Neurosciences, University of California, San Diego and Rady Children's Hospital, 8010 Frost Street, Suite 400, San Diego, CA 92123, USA.

Case Reports in Neurological Medicine
|March 12, 2013
PubMed

Insights

A pediatric case of cerebral proliferative angiopathy presented with stroke-like symptoms including headaches and unsteadiness. Prompt diagnosis and management led to complete symptom resolution within 24 hours, highlighting this rare condition.

Area of Science:

  • Neurology
  • Vascular Malformations
  • Pediatric Neurology

Background:

  • Cerebral proliferative angiopathy (CPA) is a rare vascular malformation.
  • It is distinct from classic arteriovenous malformations (AVMs).
  • CPA can present with stroke-like symptoms in children.

Purpose of the Study:

  • To report a case of cerebral proliferative angiopathy in a child.
  • To describe the diagnostic process and clinical presentation.
  • To emphasize the importance of recognizing CPA as a differential diagnosis in pediatric stroke mimics.

Main Methods:

  • A 9-year-old girl presented with worsening headaches and unsteadiness.
  • Neurologic examination revealed right hemiparesis and right homonymous hemianopsia.
  • Imaging studies including CT, CT angiogram, and MRI were performed.

Main Results:

  • CT showed an engorged sagittal and straight sinus with prominent cortical veins.
  • CT angiogram confirmed a left hemispheric vascular malformation consistent with CPA.
  • MRI showed no evidence of infarct, and symptoms resolved within 24 hours.

Conclusions:

  • Cerebral proliferative angiopathy can mimic other neurological emergencies in children.
  • Early diagnosis through advanced imaging is crucial.
  • Prompt management can lead to rapid symptom resolution.

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