Reversible Wall Enhancement in Pediatric Cerebral Arteriopathy

Abstract

A previously well and developmentally normal five-year-old right-handed girl, presented with acute left-sided weakness and dysarthria. Investigations confirmed an acute right lenticulostriate stroke secondary to probable childhood primary angiitis of the CNS(cPACNS), including evidence of vessel wall enhancement (Figure). Despite extensive investigations, no alternative etiology for her stroke was detected. After three weeks of steroids, the child improved and the vessel wall enhancement resolved. Moderate hemiparesis, hemidystonia, and behavioural sequelae are present at 18-month follow-up.