A 14-year-old Girl with Right-Sided Weakness and Speech Difficulty

Caitlin Moore; Rebecca Pollard; Craig A Press; Matthew Hiller; John Maloney; Megan Barry; Ryan Kammeyer

doi:10.1177/19418744211073025

A 14-year-old Girl with Right-Sided Weakness and Speech Difficulty

Neurohospitalist. 2022 Apr;12(2):408-412. doi: 10.1177/19418744211073025. Epub 2022 Feb 16.

Authors

Caitlin Moore¹, Rebecca Pollard¹, Craig A Press², Matthew Hiller², John Maloney³, Megan Barry², Ryan Kammeyer²

Affiliations

¹ Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA.
² Department of Pediatrics, Section of Child Neurology, University of Colorado School of Medicine, Aurora, CO, USA.
³ Department of Radiology, University of Colorado School of Medicine, Aurora, CO, USA.

Abstract

We herein report a case of Childhood Primary Central Nervous System (CNS) Angiitis. This case consisted of a 14-year-old girl who presented with right-sided weakness, aphasia, and a fever. A Magnetic Resonance Imaging of the brain showed multifocal areas of ischemia. Magnetic Resonance Angiography of the head and neck showed narrowing and irregularities of the left middle cerebral artery and right posterior cerebral artery. Cerebrospinal Fluid studies showed a lymphocytic pleocytosis and brain biopsy revealed leptomeningeal and perivascular inflammation. The epidemiology, presenting symptoms, work-up, pathophysiology, diagnostic criteria, and treatment of Childhood Primary CNS angiitis are discussed. This case serves as a reminder that when pediatric patients present with stroke-like symptoms inflammatory etiologies including Primary CNS Angiitis must be considered and treated appropriately in a time sensitive manner.

Keywords: childhood primary CNS angiitis; pediatric stroke; vasculitis.

Publication types

Case Reports