Acute subdural effusion in vasculitis.
We report a 29-year-old man with a unique presentation of vasculitis as acute unilateral subdural effusion and meningoencephalitis. Magnetic resonance imaging showed a brainstem lesion that spread to the thalamus over time. There were no systemic features of vasculitis other than a positive pathergy test. Histopathological examination from the pathergy site showed neutrophilic infiltrate and leucocytoclastic vasculitis. The condition was steroid responsive and he remained in remission at two years' follow-up. The anatomy of the brainstem lesion, absence of other inflammatory and infective conditions on evaluation suggests a vasculitic pathology either as primary central nervous system angiitis or as neurological presentation of systemic vasculitis like Behetaet's disease although the international diagnostic criteria for Behetaet's were not fulfilled.
Raghavendra
Seetharam
S
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology,Trivandrum, Kerala, India.
Kamath
Vidya Madavana Venugopal
VM
Sarada
C
C
Radhakrishnan
Ashalatha
A
Kesavadas
Chandrasekharan
C
Krishnamoorthy
Thamburaj
T
D000328:Adult; D001933:Brain Stem / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D013353:Subdural Effusion / Q000209:etiology* / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods; D014657:Vasculitis / Q000150:complications*