Leptomeningeal enhancement and venous abnormalities in granulomatous angiitis of the central nervous system.

Abstract

A 68-year-old woman with a relatively acute onset of right homonymous hemianopia, Gerstmann syndrome, and global cognitive failure was found to have a lymphocytic pleocytosis and elevated protein on spinal fluid examination and displayed marked meningeal enhancement on magnetic resonance imaging and dilated cortical venules on cerebral angiography. Brain and meningeal biopsy disclosed a necrotizing granulomatous inflammation of small and medium-sized subarachnoid vessels. The brain parenchyma was normal. The angiographic presence of venous abnormalities, the lack of observable angiographic arterial involvement, and the lack of parenchymal pathology are distinctly unusual in granulomatous angiitis of the central nervous system. This case, therefore, extends the pathologic and imaging spectrum of this disorder.

• Authors: Janet C Rucker, Valérie Biousse, Nancy J Newman
• Journal: Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society (J Neuroophthalmol) Vol. 23 Issue 2 Pg. 148-50 (Jun 2003) ISSN: 1070-8022 [Print] United States
• PMID: 12782929 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Topics

• Aged
• Arachnoid (pathology)
• Brain (pathology)
• Cerebral Angiography
• Cerebral Veins (pathology)
• Female
• Humans
• Magnetic Resonance Imaging
• Pia Mater (pathology)
• Vasculitis, Central Nervous System (diagnosis)