[Cerebral vasculitides].
Cerebral vasculitides can be secondary to a broad variety of conditions such as systemic disease, infections, malignancies and toxic exposures, or can be isolated to the central nervous system. When cerebral vasculitis is suspected, the diagnostic work up must be exhaustive to rule out all these potential causes of secondary vasculitis. Most often, the diagnosis of cerebral vasculitis relies on the combination of clinical, biological and radiological findings. It is definite only when based on a positive leptomeningeal biopsy. This latter should be done when the diagnostic uncertainty remains high, especially in patients with underlying systemic disease and/or infrequent or rapidly-progressive symptoms. One can probably rule out the diagnostic of cerebral vasculitis in patients in whom both MRI and cerebrospinal fluid examination are normal. For secondary cerebral vasculitis, treatment depends on the identified underlying etiology. However, corticosteroids combined with immunosuppressive drugs are usually used. Actually, there is no consensual treatment for primary angiitis of the central nervous system. The prognosis is better when diagnosis is made early and treatment started promptly.
CHU Côte-de-Nacre, université de Caen, pôle de médecine interne et d'immunologie clinique, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France.
Hubert
H
de Boysson
Anthony
A
Faivre
Christian
C
Pagnoux
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002494:Central Nervous System Infections / Q000150:complications; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008578:Meninges / Q000473:pathology; D008875:Middle Aged; D056647:Systemic Vasculitis / Q000175:diagnosis / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods; D020293:Vasculitis, Central Nervous System / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000473:pathology
D015415:Biomarkers