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Jason S. Hawley - One of the best experts on this subject based on the ideXlab platform.

  • Unihemispheric Cerebral Vasculitis: A Case Report (P6.143)
    Neurology, 2016
    Co-Authors: Michael R. Johnson, George A. Jakubek, Jason S. Hawley
    Abstract:

    Objectives: To highlight and discuss a rare case of unilateral Cerebral Vasculitis as well as the diagnostic and therapeutic challenges. Background: Unihemispheric Cerebral Vasculitis is a rare disease, which clinically mimics other insidious and progressive neurological conditions. There is a paucity of literature regarding the presentation, diagnosis, treatment and outcome of this disease. Methods: A 30 year old, man presented with several transient episodes of acute onset non-fluent aphasia, right hemiparesis, right homonymous hemianopia gradually resolving over several days. He also developed medically refractory complex partial seizures and left retinal arteritis. Dilated fundoscopic examination revealed peripheral regions of retinal arteritis restricted to the left eye. Results: Neuroimaging revealed contrast enhancement of the left middle Cerebral and posterior Cerebral artery territories in addition to angiogram attenuation of the left-sided Cerebral arteries. Systemic markers of inflammation were negative and cerebrospinal fluid studies were negative for neoplasm or infection. CT of the chest, abdomen and pelvis were also negative. A brain biopsy was performed and demonstrated findings consistent with unihemispheric Cerebral Vasculitis. The patient was treated with 5 days of IV methylprednisolone followed by eight cycles of cyclophosphamide 0.5gram/m2 infusions and demonstrated near complete resolution of cognitive, language, motor, visual and sensory symptoms over 12 months. Conclusions: Unihemispheric Vasculitis is a rare and potentially treatable disease. Only three cases of unihemispheric Cerebral Vasculitis have been reported in literature and this is the first case reporting ipsilateral retinal artery involvement. This case highlights the important clinical, radiographical and pathological findings of unihemispheric Vasculitis in addition to the potential treatments and outcomes. More research is needed for the development of markers of disease activity and the appropriate treatments for this rare condition. Disclosure: Dr. Johnson has nothing to disclose. Dr. Jakubek has nothing to disclose. Dr. Hawley has nothing to disclose.

Mohamed Boussarsar - One of the best experts on this subject based on the ideXlab platform.

  • Cerebral Vasculitis Complicating Pneumococcal Meningitis.
    European journal of case reports in internal medicine, 2018
    Co-Authors: Ahmed Khedher, Nesrine Sma, Dorsaf Slama, Nesrine Fraj, Wissem Hachfi, Mohamed Boussarsar
    Abstract:

    Introduction Cerebral Vasculitis is an uncommon life-threatening complication of community-acquired bacterial meningitis. Patient and methods We report the case of a 64-year-old woman with pneumococcal meningitis who developed parainfectious Vasculitis causing ischaemic brain damage. Cerebral magnetic resonance imaging (MRI) confirmed the diagnosis. Clinical and radiological recovery after delayed addition of corticosteroid was achieved. Discussion This report shows that the onset of neurological deficits following pneumococcal meningitis can be caused by Cerebral Vasculitis. Underdosing with antibiotics and delayed adjunctive dexamethasone seem to favour this complication. There are no guidelines for treatment but high doses of steroids led to resolution in this case. LEARNING POINTS Pneumococcal meningitis complicated by Cerebral Vasculitis can be treated with high-dose steroids.A repeat lumbar puncture is recommended to rule out relapsing or persistent infection in patients who deteriorate after 48 h of adequate antibiotic therapy.The Cerebral Vasculitis in our patient may have been caused by antibiotic underdosing and by delayed dexamethasone administration.

Pearse Morris - One of the best experts on this subject based on the ideXlab platform.

Sandra Pearson - One of the best experts on this subject based on the ideXlab platform.

T. Rajah - One of the best experts on this subject based on the ideXlab platform.

  • Cerebral Vasculitis in ulcerative colitis.
    Archives of neurology, 2006
    Co-Authors: Jeyaraj D. Pandian, Robert D. Henderson, John D. O'sullivan, T. Rajah
    Abstract:

    Cerebral Vasculitis leading to stroke in ulcerative colitis has rarely been reported.1-2 A 35-year-old woman with severe ulcerative colitis receiving cyclosporine and prednisolone sought care for right-sided weakness and unsteady gait lasting for 5 days. Diffusion brain magnetic resonance images showed infarction in the left anterior Cerebral artery territory (Figure 1). Digital subtraction angiographic images of the intracranial vessels showed multiple areas of stenosis and dilatation (beaded appearance) involving the left middle Cerebral, anterior Cerebral, and posterior Cerebral arteries (Figure 2). These appearances were strongly suggestive of Cerebral Vasculitis. Cyclosporine levels were in the nontoxic range. Magnetic resonance angiogram taken 1 month after cessation of cyclosporine showed similar findings.