Radiological approach to disorders of arterial brain vessels associated with childhood arterial stroke - a comparison between MRA and contrast angiography

Recent studies of arterial ischaemic stroke in children have emphasised the higher frequency of cerebral arterial abnormalities than believed previously, explaining some of the strokes thought to have been idiopathic. Moreover, recurrent strokes are significantly more frequent in children with multiple risk factors, including those with demonstrable vascular abnormalities. Thus, cerebral arterial imaging is essential for the understanding and therapeutic approach to this pathology. Contrast angiography (CA) is the reference examination for the diagnosis of cerebral arterial abnormalities, but MR angiography (MRA) is a sensitive and non-invasive method to evaluate the vasculopathy of childhood stroke. In this article we highlight recent data concerning localisation and characterisation of arterial lesions and discuss the yield of MRA compared with CA.