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Diagnosing CNS Vasculitis
- Source :
- The Neurologist. 18:233-238
- Publication Year :
- 2012
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2012.
-
Abstract
- INTRODUCTION: Primary central nervous system vasculitis (PCNSV) is a rare inflammatory arteriopathy confined to the brain, spinal cord, and leptomeninges. Because of its nonspecific presentation and difficulties in making a positive diagnosis, empiric treatment is often instituted. CASE SERIES: We report a case series of 5 patients who were admitted or transferred to the Johns Hopkins Hospital with a clinical history and magnetic resonance imaging findings suggestive of PCNSV. Four patients had received at least 1 course of immunosuppression with high-dose intravenous (IV) corticosteroids and/or a corticosteroid-sparing agent. Each underwent an extensive workup including 4-vessel cerebral angiography and, in the majority of cases, brain biopsy to evaluate for mimics of PCNSV. In each of the 5 cases, an alternative diagnosis was found. CONCLUSIONS: We propose a cautious, multistep approach to the diagnosis of PCNSV, which takes into account more common diagnoses and avoids the pitfalls of empiric treatment.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Diagnosis, Differential
medicine
Humans
Medical diagnosis
Vasculitis, Central Nervous System
Stroke
Aged
medicine.diagnostic_test
Brain Neoplasms
business.industry
Brain biopsy
Magnetic resonance imaging
Immunosuppression
General Medicine
Middle Aged
Intracranial Arteriosclerosis
medicine.disease
Surgery
Cerebral Amyloid Angiopathy
Vasoconstriction
Female
Lymphoma, Large B-Cell, Diffuse
Neurology (clinical)
Radiology
Differential diagnosis
business
Vasculitis
Immunosuppressive Agents
Cerebral angiography
Subjects
Details
- ISSN :
- 10747931
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- The Neurologist
- Accession number :
- edsair.doi.dedup.....421f6fbf5b400ee18e41d8f825ad738c