Acute central nervous system vasculitis as a manifestation of neurosarcoidosis: A case report and literature review

• Main Authors: Toyonobu Maekawa, MD, Yukihiro Goto, MD, PhD, Takuma Aoki, MD, Akihiko Hino, MD, PhD, Hideki Oka, MD, Shigeomi Yokoya, MD, PhD, Akihiro Fujii, MD, PhD
• Format: Article
• Language: English
• Published: Elsevier 2021-02-01
• Series: Radiology Case Reports
• Subjects: Acute vasculitis; Central nervous system vasculitis; Cerebral vasculitis; Neurosarcoidosis
• Online Access: http://www.sciencedirect.com/science/article/pii/S1930043320306245

Neurosarcoidosis (NS) affects various sites of the central nervous system, including the cranial nerve, meninges, brain parenchyma, hypothalamus, and pituitary gland. NS rarely causes intracerebral vasculitis and subsequent strokes, or cerebral infarction and hemorrhage, which are associated with high mortality. Herein, we report a 71-year-old woman's case of stroke associated with NS, which showed aggressive cerebral vasculitis with brain herniation; it was resolved with corticosteroid therapy after accurate histopathological diagnosis. This case highlights the necessity of expecting NS to sometimes follow an aggressive course, presenting with vasculitis. Most patients with NS satisfactorily respond to corticosteroids, but this is not always the case. In cases of unfamiliar ischemic or hemorrhagic lesions, the possibility of NS must be considered.