Gliomatosis cerebri angiographically mimicking central nervous system angiitis: case report.
OBJECTIVE
The diagnosis of isolated central nervous system angiitis often requires both cerebral angiography and biopsy for diagnosis.


METHODS
We present a case of gliomatosis cerebri with demonstrated angiographic changes suggestive of a central nervous system vasculitis.


METHODS
A 47-year-old woman presented with a 2-week history of worsening headache and progressive drowsiness. Magnetic resonance imaging scans revealed confluent nonenhancing T2-weighted hyperintensity involving the frontal white matter bilaterally, hypothalamus, and both thalami. A four-vessel angiogram revealed diffuse arterial beading with stenoses of a right frontal middle cerebral artery branch and the distal posterior cerebral artery and anterior cerebral artery branches, bilaterally. The biopsy revealed a Grade 2 fibrillary astrocytoma consistent with gliomatosis cerebri.


CONCLUSIONS
Gliomatosis cerebri can mimic central nervous system vasculitis angiographically. Perivascular infiltration by tumor cells may be responsible for these changes.
Maramattom
Boby V
BV
Division of Critical Care Neurology, Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Giannini
Caterina
C
Manno
Edward M
EM
Wijdicks
Eelco F M
EF
Campeau
Norbert G
NG
D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018302:Neoplasms, Neuroepithelial / Q000175:diagnosis*; D014657:Vasculitis / Q000175:diagnosis*