Successful emergent angioplasty of neurosarcoid vasculitis presenting with strokes.
BACKGROUND
Sarcoidosis is a systemic disease with neurologic involvement in approximately 5% of cases. Ischemic events related to neurosarcoid vasculitis are rare. We report the successful treatment of symptomatic neurosarcoid vasculitis with angioplasty.


METHODS
A 41-year-old African American with a diagnosis of neurosarcoid presented with aphasia and right-sided weakness. He was treated medically with antiplatelet agents, heparinization, and hypertensive therapy. Despite this treatment, he experienced clinical worsening and radiographic extension of his infarcts. He underwent successful angioplasty of a severe focal stenosis of the left middle cerebral artery. After the procedure, he experienced marked improvement in his symptoms and at follow-up continues to improve.


CONCLUSIONS
We report the angiographic demonstration of neurosarcoidosis with large vessel changes and resultant strokes and its successful treatment with balloon angioplasty.
Brisman
Jonathan L
JL
Department of Cerebrovascular and Endovascular Neurosurgery, New Jersey Neuroscience Institute at JFK Medical Center, Edison, NJ 08818, USA. jbrisman@solarishs.org
Hinduja
Archana
A
McKinney
James S
JS
Gerhardstein
Brian
B
D000328:Adult; D000800:Angioplasty, Balloon / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000925:Anticoagulants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001037:Aphasia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001921:Brain / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D002533:Cerebral Angiography; D018450:Disease Progression; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D012507:Sarcoidosis / Q000150:complications* / Q000503:physiopathology; D020521:Stroke / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D020293:Vasculitis, Central Nervous System / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*
D000925:Anticoagulants; D000959:Antihypertensive Agents