Figura. Proyecciones laterales de arteriografía en las que se evidencia la extravasación de contraste (flechas) correspondiente con las soluciones de continuidad de la pared de los vasos, hallazgos compatibles con una vasculitis cerebral.
Non-aneurysmal subarachnoid haemorrhage secondary to panarteritis nodosa at paediatric age:
a case report
Introduction. Polyarteritis nodosa is a necrotizing vasculitis that mainly affects small and medium-sized arteries in skin and internal organs. Neurological involvement is reported in around 25% of cases: ischemic stroke is relatively common, but haemorrhagic lesions are extremely rare. Subarachnoid haemorrhage in polyarteritis nodosa is an uncommon expression of this disease, mostly associated with aneurism rupture. To the best of the authors’ knowledge, there is just one published case in pediatric age with polyarteritis nodosa and subarachnoid haemorrhage with no underlying aneurismal disease.
Case report. A 7-year-old girl, who presented a non-aneurismal subarachnoid haemorrhage with intraparenchymal extension in the left basal ganglia. She was previously diagnosed with polyarteritis nodosa and prothrombotic condition, being under immunosuppressive and anti-platelet treatment at that moment.
Conclusions. The clinical features of polyarteritis nodosa together with continued anti-platelet therapy to prevent thromboembolic disease in this patient could have predisposed to the haemorrhagic event in the process of cerebral vasculitis. Standard subarachnoid haemorrhage management is initially required in such cases as cerebral aneurysms are the most common cause of haemorrhage in the context of polyarteritis nodosa disease.
Key words. Cerebral vasculitis. Intracranial aneurysms. Neuroradiology. Paediatric age. Panarteritis nodosa. Subarachnoid haemorrhage.