Intracranial stenosis treated with stenting in patient with suspected cerebral vasculitis: two case reports.
Central nervous system vasculitis (CNSV) is an uncommon and poorly understood form of vasculitis. Early recognition is important because medical treatment might improve the outcome. However, randomized clinical trials on CNSV treatment do not exist. Endovascular treatment has been reported in few ca...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Karger Publishers
2023-05-01
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| Series: | Case Reports in Neurology |
| Online Access: | https://beta.karger.com/Article/FullText/529942 |
| _version_ | 1827930819822354432 |
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| author | Gabriele Vandelli Laura Giacobazzi Ludovico Ciolli Maria Luisa Dell'Acqua Laura Vandelli Livio Picchetto Francesca Rosafio Giuseppe Maria Borzì Riccardo Ricceri Stefano Meletti Stefano Vallone Carlo Salvarani Marco Sebastiani Federico Sacchetti Luca Verganti Stefano Merolla Gabriele Zelent Guido Bigliardi |
| author_facet | Gabriele Vandelli Laura Giacobazzi Ludovico Ciolli Maria Luisa Dell'Acqua Laura Vandelli Livio Picchetto Francesca Rosafio Giuseppe Maria Borzì Riccardo Ricceri Stefano Meletti Stefano Vallone Carlo Salvarani Marco Sebastiani Federico Sacchetti Luca Verganti Stefano Merolla Gabriele Zelent Guido Bigliardi |
| author_sort | Gabriele Vandelli |
| collection | DOAJ |
| description | Central nervous system vasculitis (CNSV) is an uncommon and poorly understood form of vasculitis. Early recognition is important because medical treatment might improve the outcome. However, randomized clinical trials on CNSV treatment do not exist. Endovascular treatment has been reported in few cases, but no data exist for intracranial stenting.
We report two cases of patients with suspected CNSV and recurrent clinical episodes, treated with intracranial stenting.
A 48-year-old man had relapsing episodes of right hemiparesis. Neuroradiological exams showed severe left carotid terminus stenosis. Despite immunosuppressive therapy, neuroradiological follow-up exams showed a worsening of the aforementioned stenosis with many transient episodes of weakness in the right limbs and aphasia.
A 64-year-old woman had a sudden onset of dysarthria and transient aphasia. Neuroradiological exams showed a severe arterial stenosis involving the origin of left ACA and MCA. Despite dual antiplatel therapy she presented an acute onset of severe aphasia, due to an occlusion of the left carotid terminus and proximal MCA.
In both cases endovascular procedure and intracranial stenting was performed, with marked improvement of cerebral blood flow. No more clinical episodes were reported.
Intracranial stenting may be a valid therapeutic option in selected patients with CNSV and involvement of medium or large size vessels with clinical worsening despite best medical treatment. |
| first_indexed | 2024-03-13T06:43:01Z |
| format | Article |
| id | doaj.art-2044288656b24700bff3f8a76cbd16f7 |
| institution | Directory Open Access Journal |
| issn | 1662-680X |
| language | English |
| last_indexed | 2024-03-13T06:43:01Z |
| publishDate | 2023-05-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Neurology |
| spelling | doaj.art-2044288656b24700bff3f8a76cbd16f72023-06-08T12:42:06ZengKarger PublishersCase Reports in Neurology1662-680X2023-05-011110.1159/000529942529942Intracranial stenosis treated with stenting in patient with suspected cerebral vasculitis: two case reports.Gabriele VandelliLaura GiacobazziLudovico CiolliMaria Luisa Dell'AcquaLaura VandelliLivio PicchettoFrancesca RosafioGiuseppe Maria BorzìRiccardo RicceriStefano MelettiStefano ValloneCarlo Salvaranihttps://orcid.org/0000-0003-3708-3148Marco SebastianiFederico SacchettiLuca VergantiStefano MerollaGabriele ZelentGuido BigliardiCentral nervous system vasculitis (CNSV) is an uncommon and poorly understood form of vasculitis. Early recognition is important because medical treatment might improve the outcome. However, randomized clinical trials on CNSV treatment do not exist. Endovascular treatment has been reported in few cases, but no data exist for intracranial stenting. We report two cases of patients with suspected CNSV and recurrent clinical episodes, treated with intracranial stenting. A 48-year-old man had relapsing episodes of right hemiparesis. Neuroradiological exams showed severe left carotid terminus stenosis. Despite immunosuppressive therapy, neuroradiological follow-up exams showed a worsening of the aforementioned stenosis with many transient episodes of weakness in the right limbs and aphasia. A 64-year-old woman had a sudden onset of dysarthria and transient aphasia. Neuroradiological exams showed a severe arterial stenosis involving the origin of left ACA and MCA. Despite dual antiplatel therapy she presented an acute onset of severe aphasia, due to an occlusion of the left carotid terminus and proximal MCA. In both cases endovascular procedure and intracranial stenting was performed, with marked improvement of cerebral blood flow. No more clinical episodes were reported. Intracranial stenting may be a valid therapeutic option in selected patients with CNSV and involvement of medium or large size vessels with clinical worsening despite best medical treatment.https://beta.karger.com/Article/FullText/529942 |
| spellingShingle | Gabriele Vandelli Laura Giacobazzi Ludovico Ciolli Maria Luisa Dell'Acqua Laura Vandelli Livio Picchetto Francesca Rosafio Giuseppe Maria Borzì Riccardo Ricceri Stefano Meletti Stefano Vallone Carlo Salvarani Marco Sebastiani Federico Sacchetti Luca Verganti Stefano Merolla Gabriele Zelent Guido Bigliardi Intracranial stenosis treated with stenting in patient with suspected cerebral vasculitis: two case reports. Case Reports in Neurology |
| title | Intracranial stenosis treated with stenting in patient with suspected cerebral vasculitis: two case reports. |
| title_full | Intracranial stenosis treated with stenting in patient with suspected cerebral vasculitis: two case reports. |
| title_fullStr | Intracranial stenosis treated with stenting in patient with suspected cerebral vasculitis: two case reports. |
| title_full_unstemmed | Intracranial stenosis treated with stenting in patient with suspected cerebral vasculitis: two case reports. |
| title_short | Intracranial stenosis treated with stenting in patient with suspected cerebral vasculitis: two case reports. |
| title_sort | intracranial stenosis treated with stenting in patient with suspected cerebral vasculitis two case reports |
| url | https://beta.karger.com/Article/FullText/529942 |
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