title: Leptomeningeal rheumatoid nodules: diagnosis and failed therapeutics.
abstract: A 67-year-old woman presented with recurrent transient ischaemic attack-like episodes over a 2 year period. Nodular enhancing leptomeningeal changes were detected on MRI and were consistent with meningeal rheumatoid nodules on biopsy. The patient's nodular disease continued to progress and regress clinically and radiologically irrespective of disease modifying agents and peripheral and serological rheumatoid arthritis control. This patient's unique presentation and diagnostic work-up is discussed alongside the dilemma of therapeutic management of meningeal rheumatoid nodules.
authors.affiliation: Department of Neurology, Barwon Health/Geelong Hospital, Ryrie Street, Geelong, P.O. Box 281, VIC 3220, Australia. Electronic address: cassie_nesbitt@hotmail.com.
authors.forename: Cassie
authors.initials: C
authors.lastname: Nesbitt
authors.affiliation: Department of Neurology, Barwon Health/Geelong Hospital, Ryrie Street, Geelong, P.O. Box 281, VIC 3220, Australia.
authors.forename: Luke
authors.initials: L
authors.lastname: Willshire
authors.affiliation: Department of Radiology, Barwon Health/Geelong Hospital, Geelong, VIC, Australia.
authors.forename: Doreen
authors.initials: D
authors.lastname: Quan
authors.affiliation: Department of Neuroscience, Barwon Health/Geelong Hospital, Geelong, VIC, Australia.
authors.forename: Cameron
authors.initials: C
authors.lastname: Shaw
authors.affiliation: Department of Neuroscience, Barwon Health/Geelong Hospital, Geelong, VIC, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Batchelor
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D016080:Arachnoid Cysts / Q000175:diagnosis* / Q000628:therapy*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology; D008279:Magnetic Resonance Imaging; D012008:Recurrence; D012218:Rheumatoid Nodule / Q000175:diagnosis* / Q000628:therapy*; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents
keywords: Biopsy; Brain; Immunomodulators; Leptomeningeal; Rheumatoid nodules