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[Inflammatory cerebro-vascular disease: angiographic findings and distribution patterns (author's transl)]
Insights
Cerebral angiography reveals characteristic patterns for diagnosing inflammatory cerebrovascular diseases. Specific findings help classify conditions like meningitis, arteritis, and mycotic aneurysms, aiding differential diagnosis.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Inflammatory cerebrovascular diseases present diagnostic challenges.
- Cerebral angiography, while requiring caution, offers valuable insights.
Purpose of the Study:
- To detail characteristic angiographic findings in various inflammatory cerebrovascular diseases.
- To aid in the classification and differential diagnosis of these conditions.
Main Methods:
- Analysis of angiographic findings in 8 cases of inflammatory cerebrovascular disease.
- Review of characteristic patterns associated with specific conditions.
Main Results:
- Proximal arteries affected by basal meningitis and thrombangiitis obliterans (stenoses, occlusions).
- Carotid artery involvement varies by inflammation origin; tuberculous and mycotic arteritis favor the supraclinoid siphon.
- Peripheral changes seen in luetic endangiitis, necrotizing/toxic angiitis, and collagenoses.
- Temporal artery involvement indicates systemic disease (pathognomonic in Horton's arteritis).
- Embolic occlusions from infectious endocarditis, mycoses, and malaria.
- Mycotic aneurysms show broad-based or fusiform shapes.
- Abscesses, tuberculomas, and viral encephalitis appear as hypervascularized areas.
Conclusions:
- Cerebral angiography provides specific, classifiable findings for inflammatory cerebrovascular diseases.
- Angiographic patterns assist in differentiating conditions like meningitis, arteritis, and aneurysms.
- Temporal artery involvement is a key indicator of systemic inflammatory processes.
Abstract:
Although cerebral angiography should be approached with caution in the diagnosis of inflammatory cerebro-vascular disease there are some characteristic angiographic findings which may be helpful for classification and differential diagnosis. The proximal cerebral arteries are favourably affected by basal meningitis and thrombangiitis obliterans with resulting stenoses and occlusions. Whereas those inflammations originating from neighbouring skull structures mostly involve the intracavernous parts of the carotid artery, the tuberculous and mycotic arteritis prefer the supraclinoid carotid siphon. Peripheral vascular changes are found in luetic endangiitis, necrotizing and toxic angiitis and in collagenoses. Simultaneous involvement of the temporal arteries is of great diagnostic importance demonstrating the systemic character of the inflammatory process; in Horton's arteritis it can be a pathognomonic finding. Infectious endocarditis, some mycoses and malaria may lead to embolic occlusion of cerebral vessels. Mycotic aneurysms mostly have a broad base or a fusiform shape and do not prefer the localizations of congenital aneurysms. Angiographically, abscesses, tuberculomas and viral encephalitis may result in circumscribed hypervascularized areas. The characteristic angiographic findings are exemplified and discussed on the basis of 8 cases of inflammatory cerebro-vascular disease (tuberculosis, pneumococcal and unspecific bacterial meningitis, syphilis, mycosis, Takayasu-syndrome, panarteritis nodosa, temporal arteritis).