1/23. magnetic resonance angiography of primary varicella vasculitis: report of two cases.Two patients with onset of hemiparesis 3 weeks following primary varicella infection demonstrated contralateral temporal lobe and basal ganglia infarctions on magnetic resonance imaging. In both cases, magnetic resonance angiography (MRA) was performed and demonstrated flow abnormalities ipsilateral to the infarcts. Digital subtraction angiography was performed in one case; however, the findings were significantly less conspicuous than those of the MRA. MRA proved to be sensitive to the diagnosis of varicella-induced vasculitis in two consecutive cases and provided a noninvasive means of following the progression of the disease process in response to therapy.- - - - - - - - - - ranking = 1keywords = vasculitis (Clic here for more details about this article) |
2/23. multiple sclerosis with extensive lesions left hemiplegia, mental dysfunction and retrobulbar neuritis.multiple sclerosis (MS) is usually diagnosed on the basis of the typical clinical course, with remission and exacerbation in multiple parts of the central nervous system (CNS). Recently, magnetic resonance imaging (MRI) has made a large contribution to the diagnosis of patients with MS. But it is difficult to make a definite diagnosis due to clinical variability of the disease and variable MRI findings. We report the case of a 26-year-old woman who developed progressive left hemiplegia, mental dysfunction, and had extensive bilateral cerebral white matter lesions diagnosed by brain MRI. Complete recovery from the left hemiplegia followed the use of corticosteroid, and her brain MRI findings also improved after medication. Early in the clinical course it was difficult to differentiate between multiple sclerosis and granulomatous angiitis of the CNS. After recovery from the first episode of left hemiplegia and mental dysfunction, she developed acute visual disturbance five months after her first admission. Readmission followed and her retrobulbar neuritis was successfully treated by methylpredonisolone pulse therapy. In summary, she experienced two episodes of neurological deficit, had left hemiplegia and mental dysfunction associated with multiple lesions in bilateral cerebral white matter in brain MRI, and the left retrobulbar neuritis with delay of P100 by visual evoked potential study. Due to these two episodes we concluded that she had multiple sclerosis. Though the initial diagnosis was difficult, prompt treatment and close follow-up was important, since multiple sclerosis and granulomatous angiitis of the CNS can both recur.- - - - - - - - - - ranking = 654.08976168228keywords = granulomatous angiitis, angiitis (Clic here for more details about this article) |
3/23. Temporal artery biopsy in herpes zoster ophthalmicus with delayed arteritis.A 58-year-old man developed herpes zoster ophthalmicus with delayed hemiparesis. Temporal artery biopsy confirmed the presence of a vasculitis. Electron microscopy of the temporal artery failed to reveal viral particles. herpes zoster ophthalmicus with delayed arteritis appeared to be a contiguous spread of vasculitis to the carotid system and not a direct viral invasion.- - - - - - - - - - ranking = 0.4keywords = vasculitis (Clic here for more details about this article) |
4/23. Acute hemiplegia associated with herpes zoster infection in children: report of one case.Herpes zoster infection has been rarely reported to cause angiitis of the central nervous system in children. We describe a 4-year, 8-month-old female with acute hemiplegia and central facial palsy 6 weeks after she had had zoster ophthalmicus. The findings of magnetic resonance angiography, the clinical picture, and a preceding history of herpes zoster ophthalmicus suggested zoster vasculitis. Herpes zoster vasculitis is thus another consideration when examining a child with acute hemiplegia and a recent herpes zoster infection.- - - - - - - - - - ranking = 99.319092802256keywords = angiitis, vasculitis (Clic here for more details about this article) |
5/23. Granulomatous angiitis of the central nervous system associated with herpes zoster.Granulomatous angiitis of central nervous system (CNS) is a rare inflammatory disease of blood vessels mostly confined to CNS. We describe a case which presented with right sided hemiplegia with aphasia, after herpes zoster ophthalmicus. CT scan and MRI brain showed a large left sided infarct in the left middle cerebral artery (MCA) territory. MRI angiography revealed narrowing and thinning of left internal carotid artery (ICA) and to a lesser extent, left MCA suggestive of granulomatous vasculitis. Herpes zoster is often associated with major CNS involvement and a vascular etiology was previously postulated. Recent pathological reports suggest that cerebral angiitis secondary to herpes virus infection may be more common than realised.- - - - - - - - - - ranking = 593.71455681354keywords = angiitis, vasculitis (Clic here for more details about this article) |
6/23. Varicella with delayed hemiplegia.We report 4 children who developed acute hemiplegia 7 weeks to 4 months after varicella infection. In 2 patients, carotid angiography demonstrated segmental narrowing and occlusion of the middle cerebral artery. Their clinical and angiographic features were similar to those associated with contralateral hemiplegia after herpes zoster ophthalmicus, the pathogenesis of which comprises cerebral angiitis due to varicella zoster viral infection. We believe that our patients had the same pathogenesis. In a survey of infectious diseases in our region, the frequency of varicella with delayed hemiparesis was roughly 1:6,500 varicella patients.- - - - - - - - - - ranking = 98.919092802256keywords = angiitis (Clic here for more details about this article) |
7/23. central nervous system vasculitis after chickenpox--cause or coincidence?A 7.5 year old boy, known to have a seizure disorder, presented with an infarct in the left middle cerebral artery territory, 10 weeks after severe chickenpox. Immunofluorescent antibody titre to the varicella zoster virus in the cerebrospinal fluid was 1:32. cerebral angiography showed evidence of focal vasculitis. He presented again seven months later with an acute exacerbation of seizures. magnetic resonance imaging of the brain showed an old posterior extension of the infarct, but a repeated angiography demonstrated an improvement in the vasculitic process. cerebrospinal fluid antibody titre was again 1:32. Although this may have been an unfortunate coincidence, a possible association between chickenpox and vasculitis, similar to that reported with herpes zoster, and with potentially significant clinical implications, should be considered. As a definite proof can be obtained only by a brain biopsy, however, which is generally not indicated in such cases, only additional clinical reports can lead to delineation of this association as a definite entity.- - - - - - - - - - ranking = 1.2keywords = vasculitis (Clic here for more details about this article) |
8/23. sarcoidosis presenting with stroke.A 25-year-old black man with sarcoidosis presented with transient ischemic attacks followed by sudden, persistent right hemiparesis. He gave a history of recent, recurrent lower motor neuron facial palsy. Computed tomography demonstrated an infarct in the left internal capsule. Chest x-ray film showed bilateral hilar and mediastinal lymphadenopathy and multiple opacities in the lung fields. serum angiotensin converting enzyme concentration was raised, and a kveim test was positive for sarcoidosis. Despite clear pathologic reports of cerebral vasculitis in neurosarcoidosis, the occurrence of stroke is extremely rare.- - - - - - - - - - ranking = 0.2keywords = vasculitis (Clic here for more details about this article) |
9/23. Mycotic aneurysm in angiitis associated with herpes zoster ophthalmicus.Varicella zoster (VZ) is an unusual cause of CNS angiitis, usually occurring in older patients and immunocompromised hosts. The infection most commonly presents as herpes zoster ophthalmicus with contralateral hemiplegia. Mycotic aneurysm formation associated with VZ angiitis is rare. We report two cases of VZ angiitis with mycotic aneurysm formation (both aneurysms eventually ruptured) and one case of probable VZ angiitis with distal carotid occlusion and cerebral infarction. The CT and angiographic appearances, clinical course, and histopathology are presented.- - - - - - - - - - ranking = 791.35274241805keywords = angiitis (Clic here for more details about this article) |
10/23. herpes zoster ophthalmicus and granulomatous angiitis. An ill-appreciated cause of stroke.The syndrome of granulomatous angiitis related to varicella zoster virus infection often manifests as herpes zoster ophthalmicus followed by contralateral hemiplegia. Forty-five cases have been reported to date, and the authors' experience with two additional cases seen in a one-year period is described. Given the frequency of both stroke and herpes zoster ophthalmicus in an aging population, the authors postulate that granulomatous angiitis is underdiagnosed. There is need for increased awareness of this disease by the non-neurologist. Diagnostic and therapeutic considerations are reviewed.- - - - - - - - - - ranking = 1962.2692850468keywords = granulomatous angiitis, angiitis (Clic here for more details about this article) |
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