Clinical Presentation of Paediatric Endovascular Proliferative Angiopathy of Middle Cerebral Artery
Dr. Ramesh Sangle, Dr. Sanjay S Vhora, Dr. Mayur V Barhate, Dr. C Raman, Dr. Jay Gunjkar, Dr. Madhur Pardasani
A well-developed girl child presented with two generalised seizures at 4-years of her age. She had well developed brain parenchyma as seen on computerised tomography (CT). She presented again at 11years of her age with hemiparesis and hydrocephalus ex vacuo as seen on brain magnetic resonance imaging (MRI). MR-angiography showed endoluminal steno-occlusive angiopathy of the middle cerebral artery (MCA).rnClinical history probably indicates natural history of endoluminal proliferative-angiopathy where-in, well developed brain parenchyma becomes completely atrophic in 6-7 years. It also reflects significance of angiographic diagnostic neuroimaging and early-intervention. It’s a rare case wherein angiopathy remained unilateral & without moyamoya formation. Phylogenetic and molecular anatomy of middle cerebral artery (MCA) explains underlying vascular etiopathological process. rnKey to success is table-mapping neurocognitive functions and therapeutic window period for prevention of brain atrophy.