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Published on: September 19, 2010
Granulomatosis with CNS involvement: a neuroimaging clinicopathologic correlation
Ali A Baaj1, Fernando L Vale, John D Carter
1Department of Neurology and Neurosurgery, University of South Florida, Tampa, Florida 33606, USA.
Summary
A rare case of Wegener's granulomatosis (WG) presenting with central nervous system (CNS) involvement is detailed. Intracranial dural lesions can indicate WG, a rheumatologic disorder, necessitating consideration in differential diagnoses.
Area of Science:
- Neurology
- Rheumatology
- Pathology
Background:
- Presents a rare case of a rheumatologic disorder with central nervous system (CNS) manifestation.
- Highlights the diagnostic challenge of Wegener's granulomatosis (WG) presenting atypically.
Observation:
- A 48-year-old female with a history of scleritis refractory to immunosuppression developed headaches and parasthesias.
- Brain MRI revealed an extra-axial, enhancing, left frontoparietal convexity lesion.
Findings:
- Pathology confirmed dural granulomatosis with vasculitis, consistent with intracranial Wegener's granulomatosis.
- Elevated erythrocyte sedimentation rate (ESR) was noted in laboratory analysis.
Implications:
- Intracranial dural lesions can be a manifestation of Wegener's granulomatosis.
- Wegener's granulomatosis should be considered in the differential diagnosis of enhancing intracranial dural lesions.
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