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Multiple bilateral non-hemorrhagic cerebral infarctions associated with microscopic polyangiitis

Bon D Ku1, Hyun Young Shin

  • 1Department of Neurology, Myongji Hospital, Kwangdong University College of Medicine, 697-24, Hwajung Dukyang, Goyang, Gyeonggi 412-270, Republic of Korea. neurodasan@paran.com

Clinical Neurology and Neurosurgery
|September 8, 2009
PubMed

Insights

Microscopic polyangiitis (MPA) rarely causes cerebrovascular issues. This case highlights MPA presenting with multiple non-hemorrhagic cerebral infarctions during steroid pulse therapy.

Area of Science:

  • Rheumatology
  • Neurology
  • Vascular Medicine

Background:

  • Microscopic polyangiitis (MPA) is a systemic small vessel vasculitis.
  • Cerebrovascular disease is an uncommon complication of MPA, typically presenting as hemorrhage.

Observation:

  • A 66-year-old woman with diagnosed MPA developed multiple bilateral non-hemorrhagic cerebral infarctions.
  • The patient was undergoing steroid pulse therapy for MPA.

Findings:

  • The MPA diagnosis was confirmed by painful mononeuritis multiplex, pulmonary fibrosis, elevated myeloperoxidase, and sural nerve biopsy.
  • This case demonstrates a rare presentation of MPA with ischemic stroke.

Implications:

  • This case expands the spectrum of neurological complications associated with microscopic polyangiitis.
  • Highlights the importance of considering ischemic cerebrovascular events in MPA patients, even during treatment.

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