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Published on: February 8, 2019
Isolated cerebral vasculitis associated with rheumatoid arthritis
Núria Caballol Pons1, Núria Montalà, José Valverde
1Department of Neurology, Hospital Dos de Maig, C/Dos de Maig, 301, 08025 Barcelona, Spain. nuriacaballol@hotmail.com
Joint Bone Spine
|May 18, 2010
Summary
Central nervous system vasculitis is a rare rheumatoid arthritis complication. High-dose intravenous corticosteroids effectively treated a patient with cerebral vasculitis, showing radiological improvement.
Area of Science:
- Neurology
- Rheumatology
- Pathology
Background:
- Rheumatoid arthritis (RA) infrequently involves the central nervous system.
- Reported CNS lesions in RA are typically rheumatoid nodules or vasculitis.
- This case highlights an unusual presentation of RA-associated CNS vasculitis.
Observation:
- A 71-year-old woman with 15-year history of seropositive RA presented with headache and dysarthria.
- MRI revealed right cerebral hemisphere FLAIR hyperintensity and meningeal enhancement.
- Brain biopsy confirmed necrotizing and lymphocytic vasculitis in meninges and parenchyma.
Findings:
- The patient received high-dose intravenous methylprednisolone.
- Radiological improvement was observed at 6-month follow-up.
- Neurological symptoms resolved, and she remained asymptomatic for years.
Implications:
- Cerebral vasculitis is a rare but significant central nervous system complication of rheumatoid arthritis.
- High-dose intravenous corticosteroids demonstrate potential efficacy in treating RA-associated cerebral vasculitis.
- This case underscores the importance of considering vasculitis in RA patients with neurological symptoms.
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