Authors: SongBin Qu Sofia Khan Hua Liu
Publish Date: 2009/04/16
Volume: 30, Issue: 1, Pages: 127-134
Abstract
Primary central nervous system vasculitis PCNSV is a rare inflammatory disease causing significant morbidity and mortality We present a detailed history and clinical course of a patient with PCNSV along with a literature review A 50yearold Chinese female presented with a 6month history of mild to moderate headache and sudden onset of visual loss Early computed tomography of the brain showed multifocal infarctions Over 3 weeks after admission her clinical presentations changed considerably and her condition deteriorated She became confused then fell in to semicoma and developed leftsided paralysis and quadriparesis At about 7 months after her illness a magnetic resonance imaging of the brain revealed a tumourlike mass lesion within the right parietal lobe resulting in compressed posterior horn of the right lateral ventricle In the end a brain biopsy identified extensive vessel inflammation which established the diagnosis of PCNSV Steroid and immunosuppressive therapy dramatically improved the patient’s condition Our report highlights the importance of considering PCNSV as a differential diagnosis in patients who are suspected with encephalitis multiple sclerosis cerebral haemorrhage cerebral thrombus leukoencephalopathy or brain tumour etc while their clinical presentations are exceptionally so changeable This case also gives emphasis to the value of a brain biopsy in consolidating the diagnosis and the efficacy of steroid and immunosuppressive therapy in PCNSV
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