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Cerebral vasculitis presenting as a stroke
Maxine Montefort1, Umesh Dashora, Muhammad Chowdhury
1Department of Diabetes and Endocrinology, Conquest Hospital, East Sussex Healthcare Trust, St. Leonards on Sea, UK. maxinemontefort@gmail.com
BMJ Case Reports
|November 29, 2012
Summary
Primary angitis of the brain, a rare condition, can cause stroke-like symptoms such as arm weakness and numbness. Early diagnosis via biopsy and treatment with immunosuppressants are crucial for managing this neurological disorder.
Area of Science:
- Neurology
- Neuroimmunology
- Vascular Neurology
Background:
- Primary angitis of the brain is a rare, potentially devastating condition characterized by inflammation of blood vessels in the brain.
- It can present with diverse neurological deficits mimicking other cerebrovascular diseases, posing diagnostic challenges.
Observation:
- A 57-year-old male presented with acute onset right arm weakness, numbness, dyspraxia, and speech hesitancy.
- Neurological examination revealed sensory deficits, reduced motor power on the right, and left-sided visual field impairment.
- Neuroimaging (MRI/CT) demonstrated multiple hemorrhages and infarcts, suggesting an inflammatory vasculopathy.
Findings:
- Cerebral biopsy confirmed the diagnosis of primary angitis of the brain.
- The patient exhibited a partial response to treatment with corticosteroids and immunosuppressive agents.
Implications:
- This case underscores the importance of considering primary angitis of the brain in the differential diagnosis of unexplained multifocal neurological deficits.
- Timely diagnosis through biopsy and initiation of immunosuppressive therapy are critical for improving patient outcomes.
- Further research into the pathogenesis and optimal treatment strategies for primary angitis of the brain is warranted.
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