Central nervous system vasculitis in children.
OBJECTIVE
To summarize the current literature on central nervous system vasculitis in childhood because this condition remains a diagnostic and therapeutic challenge.


RESULTS
Central nervous system vasculitis in childhood may be primary or secondary to a variety of conditions including infections, collagen vascular diseases, systemic vasculitides, and malignancies. Conditions that result in vasospasm or are associated with noninflammatory vasculopathies may mimic the features of central nervous system vasculitis. Recent studies have described the clinical spectrum of CNS vasculitis in childhood. The most common presenting features are headaches and focal neurologic deficits. The diagnosis of central nervous system vasculitis remains particularly difficult because the available investigative modalities have limited sensitivities and specificities. The most helpful diagnostic tests include cerebrospinal fluid analysis, MRI of the brain, and angiography. However, brain biopsy may be required to diagnose small vessel vasculitis.


CONCLUSIONS
This review summarizes recent data on primary central nervous system vasculitis and some of the secondary CNS vasculitides in children. Awareness of the presenting clinical features of CNS vasculitis should lead to consideration of the diagnosis. Awareness of the sensitivity and specificity of the various diagnostic tests should lead to the more prudent use of invasive diagnostic tests including angiography and brain biopsy.
Benseler
Susanne
S
Department of Pediatrics, The Hospital for Sick Children, and University of Toronto, Ontario, Canada M5G1X8.
Schneider
Rayfel
R
D001921:Brain / Q000473:pathology*; D002533:Cerebral Angiography; D002648:Child; D003520:Cyclophosphamide / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D018810:Magnetic Resonance Angiography; D017063:Outcome Assessment, Health Care; D020293:Vasculitis, Central Nervous System / Q000175:diagnosis* / Q000188:drug therapy
D007166:Immunosuppressive Agents; D003520:Cyclophosphamide