[Results of cerebral angiography performed after neuroradiological indications in children with CNS diseases].

INTRODUCTION: Despite of the constant progress in the imaging of vessels, cerebral angiography characterises with the best specificity and sensitivity in detection of arterial, arteriovenous malformations and aneurysms.

THE AIM: The aim of this study was to compare the results of cerebral angiography and other neuro-radiologic methods in cases suggesting the probability of vascular malformations in children with neurologic syndroms. MATHERIAL AND MEHTODS: In the year 2006 cerebral angiography was performed in 20 children since it was advised after radiological examinations in children hospitalized in the Department of Pediatric Neurology UJ CM in Krakó w. The group of children aged 3-17 years (mean 11 years) consisted of 11 girls and 9 boys. The commonest clinical diagnoses were epilepsy, less common cranial neuropathies, migraine, hemiparesis and agiomatosis of skin. Before cerebral angiography was indicated, other radiological examinations were performed, within CT in 7 cases, CTA in one, MRI in 17 children and MRA in 5. In some children other examinations were also performed, within transcranial doppler evaluation of cerebral blood flow, EEG, video EEG, lumbar puncture and ultrasound eye evaluation.

RESULTS: The pathological changes were detected in 5 CT examinations, 1 CTA, 7 MRI and in 4 MRA, suggesting cerebral vascular malformations. Cerebral angiography excluded vascular malformations in 15 children. In 5 children angiography confirmed however the presence of vascular pathology. In 2 of them arterial hypoplasia in the posterior circulation was detected, in 2 cases supratentorial artery hypoplasia and a single venous cerebellar malformation. Children were diagnosed with migraine with aura in two cases, within one with paresis of the right leg and single cases with skin angiomatosis, syncope and sleep myoclonus.

CONCLUSIONS: Cerebral angiography allowed to exclude vascular pathology in 75% of children, in whom previous neuroradiological examinations suggested such pathology. It was important for their quality of life. In 25% of patients angiography confirmed results of previous neuroradiological tests detecting vascular pathology. MR with contrast medium is more sensitive than angiography in detection of venous angiomas.