Neuroradiologic findings in polyarteritis nodosa.
OBJECTIVE
To demonstrate the neuroradiologic findings in patients with polyarteritis nodosa.


METHODS
A review of hospital records for a 10-year period revealed 50 patients with a discharge diagnosis of polyarteritis nodosa. Thirteen patients had undergone neuroimaging, and abnormal findings were found in 5 cases; these were the subjects of this study.


RESULTS
All 5 patients had abnormal findings on CT scans, 3 had abnormal findings on MR images, and 1 had an abnormal finding on a cerebral angiogram. All patients had cerebral cortical or subcortical infarctions, and 1 also had small infarctions within the brain stem and cerebellum. One patient had cerebral angiographic findings of arteritis. The diagnosis of arteritis was considered probable or possible in 3 other patients. Three patients had echocardiographic evidence of concentric hypertrophy and a hypocontractile left ventricle resulting from polyarteritis nodosa-related hypertension. Cardiogenic embolism was considered the likely cause in 1 patient.


CONCLUSIONS
Small peripheral cerebral infarctions, consistent with an arteritis involving medium-sized and small arteries, were the most common finding. However, cardiogenic embolism should also be considered as a possible cause of cerebral infarction in patients with polyarteritis nodosa who have left ventricular dysfunction.
Provenzale
J M
JM
Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
Allen
N B
NB
D000328:Adult; D001921:Brain / Q000098:blood supply / Q000473:pathology; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010488:Polyarteritis Nodosa / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed