[Angiitis of the central nervous system in systemic diseases].
OBJECTIVE
This review is aimed at presenting classification and diagnosis criteria of isolated central nervous system (CNS) angiitis, and at proposing guidelines for diagnosis and management of this disease.


BACKGROUND
Isolated CNS angiitis are rare and most information has been provided by studies of very small series. Angiitis can be primitive or secondary to infectious, neoplastic diseases, or toxics. Clinical manifestations and radiologic abnormalities are not specific. A brain biopsy is therefore often required to confirm the diagnosis, as numerous non-inflammatory vascular diseases can mimic both clinically and radiologically isolated CNS angiitis.


CONCLUSIONS
To help guide the diagnosis and therapeutical management of patients with CNS angiitis, strict classification criteria should be used: 1) rule out the various diseases that can mimic clinical and radiological CNS aspects related to isolated angiitis and differentiate "isolated CNS angiitis" from "CNS angiitis associated with systemic diseases"; 2) search for factors associated with the development of a "secondary CNS angiitis"; 3) check presumed mechanism at the origin of the cerebral vascular disease: "angiitis" versus "angiopathy"; 4) if the diagnosis of "primary CNS angiitis" is still suspected, it seems reasonable to perform cerebral and leptomeningeal biopsies. Treatment is still unknown and has to be discussed on a case by case basis according to the severity and progression of symptoms.
Service de neurologie, Hôpital Lariboisière, Paris, France.
V
V
Biousse
M G
MG
Bousser
D001099:Arachnoid / Q000098:blood supply / Q000473:pathology; D001424:Bacterial Infections; D001706:Biopsy; D001932:Brain Neoplasms / Q000150:complications; D002561:Cerebrovascular Disorders / Q000145:classification* / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D003937:Diagnosis, Differential; D018450:Disease Progression; D006801:Humans; D010841:Pia Mater / Q000098:blood supply / Q000473:pathology; D013116:Spinal Cord / Q000098:blood supply*; D014657:Vasculitis / Q000145:classification* / Q000175:diagnosis / Q000209:etiology / Q000473:pathology
Angéites du système nerveux central en dehors des maladies de système.