Childhood Cerebral Vasculitis : A Multidisciplinary Approach

Area of Science:

• Neurology
• Pediatrics
• Radiology

Background:

• Cerebral vasculitis is a significant cause of arterial stroke in children.
• It presents with varied neurological symptoms, including focal deficits, seizures, and encephalopathy.
• The multifactorial etiopathogenesis of childhood cerebral vasculitis (CCV) complicates classification.

Purpose of the Study:

• To review common and uncommon forms of CCV.
• To discuss the etiopathogenesis, diagnostic imaging, and advanced techniques for CCV.
• To highlight clinical, laboratory, and genetic findings crucial for diagnosis.

Main Methods:

• Comprehensive review of literature on CCV.
• Discussion of diagnostic roles of MRI, MR angiography, and vessel wall imaging.
• Emphasis on clinical manifestations, CSF, and blood results.
• Evaluation of brain and leptomeningeal biopsy utility.

Main Results:

• A stepwise diagnostic approach based on clinicoradiological findings is proposed.
• Magnetic resonance imaging (MRI) and related angiography techniques are primary imaging tools.
• Catheter angiography serves as a problem-solving tool.
• Biopsy is essential for definitive diagnosis and excluding mimics.

Conclusions:

• Accurate diagnosis of CCV requires integrating clinical, laboratory, genetic, and imaging data.
• A structured diagnostic approach aids in identifying CCV and differentiating it from other conditions.
• Advanced imaging and biopsy are key to managing childhood cerebral vasculitis effectively.