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Updated: Jul 12, 2026
09:49
Isolation and Cannulation of Cerebral Parenchymal Arterioles
Published on: May 23, 2016
[Hepatitis B associated polyarteriitis nodosa with cerebral vasculitis]
K Kohlhaas1, T Brechmann, M Vorgerd
1Neurologische Universitäts-Klinik, Bergmannsheil GmbH, Ruhr-Universität Bochum, Germany.
Deutsche Medizinische Wochenschrift (1946)
|August 24, 2007
Summary
This case study highlights a rare instance of hepatitis B-associated polyarteritis nodosa causing cerebral vasculitis. Effective treatment involved a combination of steroids and antiviral drugs, with plasmapheresis for relapses.
Area of Science:
- Neurology
- Immunology
- Infectious Diseases
Background:
- Hepatitis B virus (HBV) infection can rarely lead to systemic vasculitis.
- Cerebral vasculitis presents with diverse neurological symptoms, including psychosis and parkinsonism.
Observation:
- A 53-year-old male presented with acute brainstem syndrome, fluctuating psychosis, parkinsonism, and cerebellar signs.
- Investigations revealed HBeAg-negative hepatitis B, multiple ischemic/hemorrhagic brain lesions, and intracranial vascular irregularities suggestive of cerebral vasculitis.
Findings:
- The patient was diagnosed with hepatitis B-associated polyarteritis nodosa and cerebral vasculitis.
- Initial treatment with prednisolone and lamivudine was followed by a relapse upon steroid dose reduction, necessitating risperidone, intravenous methylprednisolone, and plasmapheresis.
Implications:
- Hepatitis B-associated polyarteritis nodosa requires a combined immunosuppressive and antiviral treatment strategy.
- Escalating steroid pulse therapy and plasmapheresis are crucial for managing relapses in severe cases.
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