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central nervous system vasculitis

Randall C Edgell, Ahmed E Sarhan, Jazba Soomro, Collin Einertson, Joanna Kemp, Peyman Shirani, Theodore K Malmstrom, Jeroen Coppens
BACKGROUND: Central nervous system vasculitis (CNSV) is a rare disorder, the pathophysiology of which is not fully understood. It involves a combination of inflammation and thrombosis. CNSV is most commonly associated with headache, gradual changes in mental status, and focal neurological symptoms. Diagnosis requires the effective use of history, laboratory testing, imaging, and biopsy. Catheter angiography can be a powerful tool in the diagnosis when common and low-frequency angiographic manifestations of CNSV are considered...
September 2016: Interventional Neurology
Marinka Twilt, Troels Herlin
In children, inflammatory brain diseases (IBrainDs) are increasingly being recognized. Clinical, neuroimaging and laboratory features are overlapping, and an exact diagnosis can be significantly delayed. Novel antibodies have been discovered and should be included in the diagnostic evaluation. Specific neuroradiological tests such as conventional angiography or vessel wall enhancement can assist in supporting the diagnosis. Brain biopsy should be considered in children with IBrainD with unclear pathology. Treatment should be tailored to the underlying pathogenesis...
October 17, 2016: Ugeskrift for Laeger
Anna Lis-Święty, Ligia Brzezińska-Wcisło, Hubert Arasiewicz
INTRODUCTION: Localized scleroderma (LoS) of the face and head is often associated with neurologic manifestations and/or imaging abnormalities in the central nervous system (CNS). CASE SERIES: We present an analysis of 20 cases of LoS affecting the face and head. The CNS symptoms and/or abnormalities in high-resolution computed tomography (HRCT) and/or magnetic resonance imaging (MRI) were observed in 12 patients (60%). In addition to the mild and unspecific disorders (e...
October 4, 2016: International Journal of Neuroscience
W Reith, C Kraus, N Harsch
CLINICAL/METHODICAL ISSUE: Vasculitis is a rare cause of diseases of the central nervous system (CNS). Vasculitis can be divided into primary and secondary forms, of which the vast majority can be manifested in various organ systems, including the CNS. Isolated vasculitis of the CNS is limited to the CNS and clinical neurological symptoms as with the other forms of vasculitis, are headaches, encephalopathy, focal deficits and seizures. A criterion of isolated CNS vasculitis is the clinical and laboratory diagnostic exclusion of other forms of vasculitis and the involvement of other organ systems...
October 2016: Der Radiologe
M Aringer, M Schneider
In the last few decades a number of small, often largely unrecognized steps have fundamentally changed the management of systemic lupus erythematosus (SLE). The current goal is to stop all disease activity without long-term use of more than 5 mg prednisolone per day. Remission, i.e. absence of activity in the SLE activity score of choice, is the defined target in the treat to target approach. The essential basic measures include life-long hydroxychloroquine as well as protection from sunlight (UV) and vitamin D substitution...
September 26, 2016: Der Internist
Patryk J Woytala, Ewa Morgiel, Anna Łuczak, Katarzyna Czesak-Woytala, Piotr Wiland
BACKGROUND: The therapeutic effects of cyclophosphamide (CP) in the treatment of systemic rheumatic diseases are related to its immune suppressive activity. However effective, the application of CP is restricted due to multiple adverse effects. OBJECTIVES: This retrospective study was conducted to determine the frequency of adverse effects attributed to CP toxicity. MATERIAL AND METHODS: The study involved 65 patients (17 male; 48 female) receiving intravenous CP between October 2007 and December 2010...
May 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Sreeja Hareendranathan Pillai, Sapna Erat Sreedharan, Girish Menon, Santhosh Kannoth, Sylaja Pn
Primary angiitis of the central nervous system (PACNS) is a rare disorder affecting both medium- and small-sized vessels. Intracranial haemorrhages though less reported are in the form of parenchymal haemorrhage and subarachnoid haemorrhage. We report a case of PACNS with intraventricular haemorrhage due to aneurysms secondary to progression of vasculitis.
July 2016: Annals of Indian Academy of Neurology
N Wilson, D Pohl, J Michaud, A Doja, E Miller
AIM: To review the long-term clinical and imaging follow-up of eight children with histopathologically proven childhood primary central nervous system angiitis (cPACNS). MATERIALS AND METHODS: Eight children (5-17 years, five female and three male patients) with biopsy-proven cPACNS vasculitis were reviewed retrospectively. All children were followed at the Children's Hospital of Eastern Ontario. Magnetic resonance imaging (MRI) images of the brain parenchyma and vessel pattern of the arteries of the circle of Willis were reviewed at baseline and follow-up(s)...
November 2016: Clinical Radiology
Joanna D Schaafsma, Ferdinand Hui, Dolora Wisco, Susan M Staugaitis, Ken Uchino, Elizabeth Kouzmitcheva, Cheryl Jaigobin, Lili-Naz Hazrati, David J Mikulis, Daniel M Mandell
No abstract text is available yet for this article.
August 16, 2016: Clinical Neuroradiology
Marco Felipe Silva, Ana Raquel Feitosa, José A Paz, Nádia Emi Aikawa, Clovis A Silva
Childhood primary angiitis of the central nervous system (cPACNS) is a rare inflammatory brain disease of unknown etiology. Of note, brain hemorrhage has been rarely reported in cPACNS patients, generally associated with a delayed clinical diagnosis, or with a diagnosis only at necropsy. We present the case of a boy with cPACNS that previously suffered an ischemic stroke. At the age of 7 years and 10 months, he presented a sudden and severe headache, vomiting and reduction in consciousness level (Glasgow coma scale 7), requiring prompt tracheal intubation...
July 2016: Revista Brasileira de Reumatologia
Hubert de Boysson, Grégoire Boulouis, Nelly Dequatre, Sophie Godard, Antoine Néel, Caroline Arquizan, Olivier Detante, Coralie Bloch-Queyrat, Mathieu Zuber, Emmanuel Touzé, Boris Bienvenu, Achille Aouba, Loïc Guillevin, Olivier Naggara, Christian Pagnoux
BACKGROUND AND PURPOSE: We aimed to describe the clinical and imaging features of patients with tumor-like presentation of primary angiitis of the central nervous system. METHODS: We retrospectively analyzed 10 patients enrolled in the French primary angiitis of the central nervous system cohort, who initially presented tumor-like brain lesions and compared them with other patients within the cohort. RESULTS: The 10 patients with tumor-like presentation in the cohort were younger and had more seizures at diagnosis than the other 75 patients (median of 37 [30-48] years versus 46 [18-79] years; P=0...
September 2016: Stroke; a Journal of Cerebral Circulation
Richard A Prayson
Intravascular lymphoma is a rare malignancy which is characterized by a proliferation of atypical appearing B cells, generally confined to vascular lumina. A tissue biopsy demonstrating the pathology is required to make a diagnosis. The tumor is often disseminated at the time of diagnosis and prognosis is poor, even with aggressive chemotherapy. Neurologic presentations of this neoplasm can be quite varied. This report documents the presence of intravascular lymphoma diagnosed on a brain biopsy in a 60-year-old man...
July 25, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
F Su, Q Qiu, D M Cai, L Q Liang, X Y Yang
OBJECTIVE: To evaluate the clinical features, treatment and prognosis of Eosinophilic Granulomatous Vasculitis. METHODS: We analyzed retrospectively the clinical and laboratory features, treatment and prognosis of 43 patients with Eosinophilic Granulomatous Vasculitis who admitted to the Department of Rheumatology of the First Affiliated University Hospital of Sun Yat-sen University between 2005 and 2014. RESULTS: Of the 43 patients, 31 patients (72...
July 19, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Álex Rovira, Cristina Auger, Antoni Rovira
Idiopathic inflammatory-demyelinating diseases (IIDDs) represent a broad spectrum of central nervous system (CNS) disorders, including monophasic, multiphasic, and progressive disorders that range from highly localized forms to multifocal or diffuse variants. In addition to the classic multiple sclerosis (MS) phenotypes, several MS variants have been described, which can be differentiated on the basis of severity, clinical course, and lesion distribution. Other forms of IIDD are now recognized as distinct entities and not MS variants, such as acute disseminated encephalomyelitis, and neuromyelitis optica spectrum disorders...
2016: Handbook of Clinical Neurology
Jose Gavito-Higuera, Carola Birgit Mullins, Luis Ramos-Duran, Cristina Ivette Olivas Chacon, Nawar Hakim, Enrique Palacios
Fungal infections of the central nervous system (CNS) pose a threat to especially immunocompromised patients and their development is primarily determined by the immune status of the host. With an increasing number of organ transplants, chemotherapy, and human immunodeficiency virus infections, the number of immunocompromised patients as susceptible hosts is growing and fungal infections of the CNS are more frequently encountered. They may result in meningitis, cerebritis, abscess formation, cryptococcoma, and meningeal vasculitis with rapid disease progression and often overlapping symptoms...
2016: Journal of Clinical Imaging Science
Yoshiyuki Abe, Naoto Tamura, Kwang-Seok Yang, Joe Matsuoka, Takayuki Kon, Ken Yamaji, Hiroshi Hashimoto, Hiroshi Tsuda, Yoshinari Takasaki
PURPOSE: To determine mortality and its predictive factors in elderly Japanese patients with severe microscopic polyangiitis (MPA). METHOD: This retrospective single-center study determined the mortality of 52 patients with MPA who were admitted to our geriatric medical center from 2002 to 2014. The variables at baseline, including patient demographics, clinical characteristics, and treatment, were analyzed for their association with mortality. RESULT: Mean age at onset of MPA was 73...
July 11, 2016: Modern Rheumatology
James Monroe Wright, Berje Haroutuon Shammassian, Jeffrey Tait Nelson, Christina Huang Wright
INTRODUCTION: The gold standard for diagnosis of central nervous system vasculitis (CNSV) is cerebral biopsy. Cerebral angiography, however, has become a common diagnostic tool for workup of this disease. Few analyses have been performed which examine the value of angiography as a stand-alone diagnostic entity or the value of cerebral biopsy in the setting of positive angiography. METHODS: A retrospective review was performed for all patients who underwent both cerebral angiography and cerebral biopsy for the workup of a presumptive diagnosis of CNSV at a single center from 2005 to 2016...
August 2016: Neurosurgery
Jose Torres, Caitlin Loomis, Brett Cucchiara, Michelle Smith, Steven Messé
BACKGROUND AND PURPOSE: The utility and safety of brain biopsy for suspected primary angiitis of the central nervous system (PACNS) are uncertain. Factors predictive of a positive biopsy have not been well described. Our aim was to evaluate the diagnostic yield and safety of brain biopsy in suspected PACNS and determine whether any prebiopsy variables are associated with a positive biopsy. METHODS: This is a retrospective study of consecutive patients who underwent diagnostic brain biopsy for PACNS at a single institution...
August 2016: Stroke; a Journal of Cerebral Circulation
Lior Zeller, Edoard Ling, Mahmoud Abu-Shakra
Behçet's disease is an inflammatory systemic disorder, characterized by a relapsing and remitting course, it manifests with oral and genital ulcerations, skin lesions, uveitis, vasculitis, central nervous system and gastrointestinal involvement. The main histopathological finding is widespread vasculitis of the arteries and veins. Therapy is variable and depends largely on the severity of the disease and organ involvement. There is common practice to treat with anticoagulation in patients suffering from vessel thrombosis, but there are no control trials to support this tendency...
February 2016: Harefuah
Danveer Bhadu, Puneet Kumar, Kiran Preet Malhotra, Aarti Sharma, Meha Sharma, Durgesh Srivastava
Microscopic polyangiitis is a small vessel vasculitis, associated with myeloperoxidaseantineutrophil cytoplasmic antibody. It rarely occurs in children. Central nervous system involvement in pediatric microscopic polyangiitis is not a well known entity with perhaps only five cases till date. We hereby present a 14-year-old girl with arthralgia, seizure, leukocytoclastic vasculitis, interstitial lung disease secondary to recurrent pulmonary hemorrhage, pauci-immune glomerulonephritis and high titers of MPO-ANCA, hence diagnostic of microscopic polyangiitis...
February 18, 2016: Acta Reumatológica Portuguesa
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