title: Unilateral intracranial arteriopathy in pediatric stroke: course, outcome, and prediction of reversible arteriopathy.
abstract: OBJECTIVE
  The nonprogressive, often reversible, unilateral arteriopathy known as transient (focal) cerebral arteriopathy has become a leading cause of childhood arterial ischemic stroke. However, it is not a well-recognized arteriopathy in East Asian countries where moyamoya disease is prevalent.
  
  
  METHODS
  We retrospectively reviewed 74 children and adolescents (<18 years) with arterial ischemic stroke and intracranial arteriopathy to identify 29 patients with unilateral large-artery arteriopathy mainly in the anterior circulation. Among them, 25 patients who fulfilled the following inclusion criteria were analyzed to determine the angiographic course and outcome: (1) repeated vascular imaging at least twice and (2) absence of thrombotic disorders or cardiac diseases.
  
  
  RESULTS
  The course of unilateral arteriopathy was classified as reversible in 17 patients (68%), progressive in 5 (20%), and stable in 3 (12%). Nine of the 17 patients with reversible arteriopathy exhibited initial worsening of the arteriopathy mostly within 1 month, but the worsened arteriopathy began to improve within 3 months and continued to improve even after a few years. Two of these 9 patients experienced stroke progression at 6 days. Of the variables analyzed, infarction involving the basal ganglia (15 of 17) and arterial beading on angiography performed within 2 weeks (10 of 12) were associated with reversible arteriopathy. Involvement of the ipsilateral posterior cerebral artery was rare (1 of 17).
  
  
  CONCLUSIONS
  The possibility of reversible arteriopathy should be suspected in children and adolescents presenting with arterial ischemic stroke and unilateral arteriopathy.
authors.affiliation: From the Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Je Young
authors.initials: JY
authors.lastname: Yeon
authors.forename: Hyung Jin
authors.initials: HJ
authors.lastname: Shin
authors.forename: Ho Jun
authors.initials: HJ
authors.lastname: Seol
authors.forename: Jong-Soo
authors.initials: JS
authors.lastname: Kim
authors.forename: Seung-Chyul
authors.initials: SC
authors.lastname: Hong
mesh_terms: D000293:Adolescent; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000453:epidemiology*; D002648:Child; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008297:Male; D009072:Moyamoya Disease / Q000000981:diagnostic imaging / Q000453:epidemiology; D020769:Posterior Cerebral Artery / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging / Q000453:epidemiology*
keywords: moyamoya disease; pediatrics; stroke