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Angiitis of the central nervous system
M Zuber1, J Blustajn, C Arquizan
1Service de Neurologie, Centre hospitalier Sainte-Anne, Paris.
Journal of Neuroradiology = Journal De Neuroradiologie
|August 13, 1999
Summary
Central nervous system angiitis involves inflammatory vascular wall lesions, presenting variably. Definitive diagnosis often requires invasive biopsy, though angiography is key for identifying cerebral artery changes.
Area of Science:
- Neurology
- Vascular Medicine
- Pathology
Background:
- Central nervous system angiitis is a rare condition characterized by inflammation of cerebral blood vessels.
- Inflammatory lesions may lead to necrosis and affect cerebral vessels of all sizes.
- Clinical presentations are diverse, ranging from focal to diffuse symptoms and acute to chronic disease courses.
Purpose of the Study:
- To review the causes, diagnostic challenges, and clinical variability of central nervous system angiitis.
- To highlight the role of angiography and biopsy in diagnosing this rare condition.
Main Methods:
- Review of existing literature on central nervous system angiitis.
- Analysis of diagnostic criteria and imaging findings, particularly angiography.
- Discussion of etiological categories including infectious, primary systemic, secondary systemic, and miscellaneous causes.
Main Results:
- Angiography is crucial, often revealing segmental stenoses and dilatations in cerebral arteries.
- A definitive diagnosis typically requires invasive cerebral or leptomeningeal biopsy, which is not always feasible.
- Causes are multifactorial, encompassing infections, systemic diseases, drug abuse, and neoplasms.
Conclusions:
- Central nervous system angiitis presents a diagnostic challenge due to its rarity and varied manifestations.
- While angiography is suggestive, biopsy remains the gold standard for definitive diagnosis.
- Understanding the diverse etiologies is essential for appropriate management of this complex neurological disorder.