Related Experiment Video

Updated: Jul 11, 2026

Lateral Chronic Cranial Window Preparation Enables In Vivo Observation Following Distal Middle Cerebral Artery Occlusion in Mice

Lateral Chronic Cranial Window Preparation Enables In Vivo Observation Following Distal Middle Cerebral Artery Occlusion in Mice

Published on: December 29, 2016

A Multidisciplinary Approach to Silent Ischaemic Strokes Unveiling Primary CNS Vasculitis: Exploring Beyond the

Syed Muhammad Meeran Hussain¹, Anum Faisal²

¹Medicine, Frimley Health NHS Foundation Trust, Frimley, GBR.

|November 17, 2025

Abstract

None:

Diagnosing first-episode strokes due to central nervous system (CNS) vasculitis is challenging, particularly when systemic vasculitis features are absent. We present the case of a 42-year-old female patient with hypertension, type 2 diabetes mellitus, and a psychiatric history, who presented with confusion and sleep disturbances. Initial CT brain revealed multiple hypodense foci suggestive of vascular insult, and MRI demonstrated multiple ischaemic infarcts in the right middle cerebral artery (MCA) territory, with features raising suspicion for medium-vessel vasculitis. Despite dual antiplatelet therapy (DAPT), she experienced further silent infarcts in the left MCA territory. A multidisciplinary evaluation, including stroke, neuroradiology, and rheumatology specialists, led to a diagnosis of CNS vasculitis based on neuroimaging findings, elevated cerebrospinal fluid (CSF) protein, negative autoimmune screen, and normal complement levels. She received intravenous methylprednisolone followed by oral prednisolone and methotrexate. Primary CNS vasculitis (PCNSV) should be considered in young patients with unexplained recurrent or silent ischaemic strokes, and a multidisciplinary approach is essential for timely diagnosis and management.

Keywords:

cns vasculitis ischaemic stroke multidisciplinary approach silent infarcts young female

More Related Videos

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

Isolation and Flow Cytometric Assessment of Neuroimmune Interactions in a Mini-Stroke Murine Model

Isolation and Flow Cytometric Assessment of Neuroimmune Interactions in a Mini-Stroke Murine Model

Published on: June 20, 2025

Related Concept Videos

Ischemic Stroke l: Introduction

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.

Ischemic Stroke ll: Pathophysiology

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...

Hemorrhagic Stroke l: Introduction

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...

Hemorrhagic Stroke ll: Pathophysiology

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...

Transient Ischemic Attack l: Introduction

Transient Ischemic Attack l: Introduction

A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...

Articles linked to this work by shared authors, journal, and citation graph.

Partial Horner's Syndrome Secondary to Carotid Dissection With an Associated Folate Deficiency.

Cureus·2025

See all related articles