[Granulomatous primary central nervous system vasculitis in a child]

Area of Science:

• Neurology
• Pediatrics
• Immunology

Background:

• Central nervous system vasculitis is a rare condition affecting blood vessels in the brain and spinal cord.
• Granulomatous inflammation is a key pathological feature, often presenting with diverse neurological symptoms.
• Pediatric cases are particularly uncommon, posing diagnostic challenges.

Purpose of the Study:

• To report a rare case of granulomatous primary central nervous system vasculitis in a 14-year-old boy.
• To highlight diagnostic findings, including neuroimaging and histopathology.
• To discuss treatment strategies and clinical outcomes in pediatric vasculitis.

Main Methods:

• Case presentation of a 14-year-old male with neurological symptoms.
• Cerebrospinal fluid analysis, cranial MRI with contrast, and susceptibility-weighted imaging.
• Brain biopsy for histopathological examination.
• Review of diagnostic criteria and treatment protocols for CNS vasculitis.

Main Results:

• The patient presented with afebrile seizure and impaired consciousness, preceded by uveitis.
• MRI revealed multiple lesions with enhancement and punctate hemorrhages, suggesting vasculitis.
• Brain biopsy confirmed inflammatory granulomatous lesions.
• No secondary causes of vasculitis were identified.

Conclusions:

• Granulomatous primary central nervous system vasculitis is a rare but treatable cause of neurological dysfunction in children.
• Multimodal diagnostic approaches, including advanced neuroimaging and biopsy, are crucial for diagnosis.
• Early immunosuppressive therapy with methylprednisolone and mycophenolate mofetil can lead to favorable outcomes.