Catastrophic Intracranial Hemorrhage as a Presenting Feature of Juvenile Polyarteritis Nodosa

Intracranial hemorrhage has been rarely reported during the course of polyarteritis nodosa. We describe a 6-year-old boy who presented with fever, altered sensorium, skin rash, hypertension, and catastrophic intracranial hemorrhage. After surgical evacuation of the intracranial hematoma, he underwen...

Full description

Saved in:
Bibliographic Details
Published in:Journal of child neurology 2014-06, Vol.29 (6), p.826-829
Main Authors: Srinivasaraghavan, Rangan, Krishnamurthy, Sriram, Mahadevan, Subramanian
Format: Article
Language:English
Subjects:
Anterior Cerebral Artery - pathology
Biopsy
Cerebral Angiography
Child, Preschool
Humans
Intracranial Hemorrhages - complications
Intracranial Hemorrhages - diagnosis
Intracranial Hemorrhages - surgery
Male
Polyarteritis Nodosa - complications
Polyarteritis Nodosa - surgery
Skin - pathology
Tomography Scanners, X-Ray Computed
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Intracranial hemorrhage has been rarely reported during the course of polyarteritis nodosa. We describe a 6-year-old boy who presented with fever, altered sensorium, skin rash, hypertension, and catastrophic intracranial hemorrhage. After surgical evacuation of the intracranial hematoma, he underwent a computerized tomography angiogram that showed narrowing of the right anterior cerebral artery. Skin biopsy showed small vessel vasculitis. Nerve conduction studies were suggestive of mononeuritis multiplex. He was diagnosed as polyarteritis nodosa and managed with immunosuppressants, to which he responded favorably. The most interesting aspect of the child’s presentation was the catastrophic onset of altered sensorium with raised intracranial pressure, which was a diagnostic challenge. The mechanisms of intracranial hemorrhage in polyarteritis nodosa and a review of the literature are discussed. The authors emphasize that it is important to recognize intracranial hemorrhage as a life-threatening complication in children with polyarteritis nodosa to institute timely therapy.
ISSN:0883-0738
1708-8283
DOI:10.1177/0883073813483902