Follow-up examinations by transcranial Doppler ultrasound in primary angiitis of the central nervous system.
BACKGROUND
Primary angiitis of the central nervous system (PACNS) is a rare disease. The definite diagnosis is made upon proof of mononuclear inflammation of the vessel wall on brain biopsy. The diagnosis can also be established on clinical grounds, typical findings on intra-arterial angiography and other investigatory grounds excluding other diseases. Therapy comprises an aggressive immunosuppressive approach. Close monitoring of the patients is mandatory. Transcranial Doppler ultrasound (TCD) has not yet been used to follow up the vasculitic lesions in PACNS.


METHODS
We report on a 32-year-old female with massive cerebral infarctions secondary to multiple large-vessel stenoses because of probable PACNS. The patient was followed closely by means of TCD. During therapy the cerebral blood flow velocities normalized as displayed by TCD. Clinical improvement followed several days after normalization of cerebral blood flow.


CONCLUSIONS
TCD is a valuable noninvasive bedside tool to monitor cerebral blood flow velocities and therapy response in patients with cerebral vasculitis, if large arteries are involved.
Department of Neurology, Universitätsklinikum Münster, Germany. ritterm@uni-muenster.de
Martin A
MA
Ritter
Rainer
R
Dziewas
Karsten
K
Papke
Peter
P
Lüdemann
D000328:Adult; D002490:Central Nervous System / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D014057:Tomography, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial; D020293:Vasculitis, Central Nervous System / Q000000981:diagnostic imaging*