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Visualizing Impairment of the Endothelial and Glial Barriers of the Neurovascular Unit during Experimental Autoimmune Encephalomyelitis In Vivo
Published on: March 26, 2019
Classification and histopathologic spectrum of central nervous system vasculitis
1Department of Pathology, School of Medicine, University of California at Davis, Davis, California, USA.
Neurologic Clinics
|March 7, 1998
Summary
Diagnosing central nervous system (CNS) vasculitis requires biopsy confirmation due to diverse causes and mimics. A negative biopsy doesn't rule out CNS vasculitis, highlighting the need for careful clinical and diagnostic correlation.
Area of Science:
- Neurology
- Immunology
- Pathology
Background:
- Central nervous system (CNS) vasculitis presents with varied etiologies and can be mimicked by nonvasculitic conditions.
- Clinical suspicion often arises from suggestive angiographic findings.
- Definitive diagnosis typically necessitates brain biopsy, especially when considering CNS vasculitis mimickers.
Purpose of the Study:
- To summarize the diagnostic challenges and implications of central nervous system vasculitis.
- To differentiate primary and secondary CNS vasculitis.
- To emphasize the role and limitations of brain biopsy in diagnosis.
Main Methods:
- Review of clinical presentations and diagnostic criteria for CNS vasculitis.
- Analysis of angiographic findings suggestive of CNS vasculitis.
- Evaluation of brain biopsy results in confirmed and suspected cases.
Main Results:
- CNS vasculitis has diverse causes and mimics, complicating diagnosis.
- Primary CNS vasculitis, though uncommon, carries a poor prognosis.
- Secondary CNS vasculitis is linked to various systemic disorders.
- A positive biopsy confirms the demonstrated vasculitis, but a negative biopsy does not exclude the disease due to focal distribution.
Conclusions:
- Brain biopsy is crucial for definitive CNS vasculitis diagnosis but has limitations.
- Clinical suspicion, imaging, and biopsy findings must be integrated for accurate diagnosis.
- The focal nature of CNS vasculitis means a single negative biopsy does not rule out the condition.
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