AJDRAJNR - American Journal of Neuroradiology

This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bert, R. J.
Right arrow Articles by Melhem, E. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bert, R. J.
Right arrow Articles by Melhem, E. R.

Polyarteritis Nodosa Presenting as Temporal Arteritis in a 9-Year-Old Child

Robert J. BertGo,a, Vittorio P. Antonaccia, Leonard Bermana and Elias R. Melhema

a From the Departments of Radiology (R.J.B., V.P.A., E.R.M.) and Pathology (L.B.), Boston Medical Center.



View larger version (246K):

[in a new window]
  		FIG 1. 9-year-old girl with left-sided monocular blindness and frontal headaches associated with tenderness over the temporal region.

A, Noncontrast CT scan shows an enlarged and dense left temporal artery (arrow). Bone window algorithm (not shown) and HU measurement showed no evidence of calcification.

B, Digital subtraction angiogram, anteroposterior view from a left common carotid injection, shows focal, long-segment stenosis (arrows) and beading (arrowheads) of the left superficial temporal artery.

C–E, Biopsy findings of the left temporal artery. Low-power view (C) shows focal irregularity and near circumferential fibrinoid necrosis in the biopsy specimen (arrows). Note the clot within the lumen of the vessel (hematoxylin-eosin; original magnification x10). Cross section of the superficial temporal artery (D) shows marked intimal hyperplasia (straight arrows) with disruption of the internal (open arrow) and external (curved arrow) elastic membranes (elastin; original magnification x40). High-power view of the vessel media (mid wall) (E) shows a mixed cellular lymphocytic-predominant infiltrate (arrows) (original magnification x100).

F and G, Contrast-enhanced T1-weighted (800/20/4) (F) and T2-weighted (2000/200/1) (G) axial brain MR images (obtained after clinical relapse, including bilateral blindness, mental status changes, and abdominal pain) show multiple peripheral focal areas of contrast enhancement and T2 prolongation involving the frontoparietal cortex (arrows).

H, Digital renal angiogram obtained 1 day after the MR study shows multiple peripheral microaneurysms (arrows), consistent with systemic PAN.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X