Unihemispheric central nervous system vasculitis
Patients with primary central nervous system vasculitis (PCNSV) usually manifest with multiple enhancing bilateral hemispheric lesions. We presented an extremely rare clinical course and follow-up of a patient with PCNSV affecting only a single (right) hemisphere. A 33-year-old previously healthy ma...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Elsevier
2017-06-01
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| Series: | eNeurologicalSci |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405650217300151 |
| _version_ | 1818943813159223296 |
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| author | Sikawat Thanaviratananich Bashar Katirji |
| author_facet | Sikawat Thanaviratananich Bashar Katirji |
| author_sort | Sikawat Thanaviratananich |
| collection | DOAJ |
| description | Patients with primary central nervous system vasculitis (PCNSV) usually manifest with multiple enhancing bilateral hemispheric lesions. We presented an extremely rare clinical course and follow-up of a patient with PCNSV affecting only a single (right) hemisphere. A 33-year-old previously healthy man presented with a left hand clonic seizure followed by a secondary generalized tonic-clonic seizure and dysarthria. MRI brain revealed multiple hyperintense lesions confined to only the right hemisphere with contrast enhancement, involving both white and grey matters. He was treated with a methylprednisolone for 5 days followed by prednisone for suspected acute disseminated encephalomyelitis without improvements. He was presented again with left-sided weakness, transient dysarthria and black objects in left visual field. MRI brain was unchanged. MR angiogram and conventional cerebral angiogram were normal. Autoimmune work-ups were all negative. A brain biopsy showed evidence of PCNSV. He was then successfully treated with intravenous cyclophosphamide followed by oral azathioprine. On a follow-up 3 years later, he remains asymptomatic on azathioprine and a repeat MRI showed all areas of enhancement were gone. |
| first_indexed | 2024-12-20T07:33:17Z |
| format | Article |
| id | doaj.art-72b5dac21961469db515f4835a95a564 |
| institution | Directory Open Access Journal |
| issn | 2405-6502 |
| language | English |
| last_indexed | 2024-12-20T07:33:17Z |
| publishDate | 2017-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | eNeurologicalSci |
| spelling | doaj.art-72b5dac21961469db515f4835a95a5642022-12-21T19:48:22ZengElseviereNeurologicalSci2405-65022017-06-017C444810.1016/j.ensci.2017.05.003Unihemispheric central nervous system vasculitisSikawat ThanaviratananichBashar KatirjiPatients with primary central nervous system vasculitis (PCNSV) usually manifest with multiple enhancing bilateral hemispheric lesions. We presented an extremely rare clinical course and follow-up of a patient with PCNSV affecting only a single (right) hemisphere. A 33-year-old previously healthy man presented with a left hand clonic seizure followed by a secondary generalized tonic-clonic seizure and dysarthria. MRI brain revealed multiple hyperintense lesions confined to only the right hemisphere with contrast enhancement, involving both white and grey matters. He was treated with a methylprednisolone for 5 days followed by prednisone for suspected acute disseminated encephalomyelitis without improvements. He was presented again with left-sided weakness, transient dysarthria and black objects in left visual field. MRI brain was unchanged. MR angiogram and conventional cerebral angiogram were normal. Autoimmune work-ups were all negative. A brain biopsy showed evidence of PCNSV. He was then successfully treated with intravenous cyclophosphamide followed by oral azathioprine. On a follow-up 3 years later, he remains asymptomatic on azathioprine and a repeat MRI showed all areas of enhancement were gone.http://www.sciencedirect.com/science/article/pii/S2405650217300151Central nervous system vasculitisVasculitisSeizureAutoimmune disease |
| spellingShingle | Sikawat Thanaviratananich Bashar Katirji Unihemispheric central nervous system vasculitis eNeurologicalSci Central nervous system vasculitis Vasculitis Seizure Autoimmune disease |
| title | Unihemispheric central nervous system vasculitis |
| title_full | Unihemispheric central nervous system vasculitis |
| title_fullStr | Unihemispheric central nervous system vasculitis |
| title_full_unstemmed | Unihemispheric central nervous system vasculitis |
| title_short | Unihemispheric central nervous system vasculitis |
| title_sort | unihemispheric central nervous system vasculitis |
| topic | Central nervous system vasculitis Vasculitis Seizure Autoimmune disease |
| url | http://www.sciencedirect.com/science/article/pii/S2405650217300151 |
| work_keys_str_mv | AT sikawatthanaviratananich unihemisphericcentralnervoussystemvasculitis AT basharkatirji unihemisphericcentralnervoussystemvasculitis |