title: Psychosis in primary angiitis of the central nervous system involving bilateral thalami: a case report.
abstract: OBJECTIVE
  To report a case of primary angiitis of the central nervous system (PACNS), a rare inflammatory disease restricted to the central nervous system (CNS), with unusual clinical presentation mimicking schizophrenia.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 45-year-old male presented with alteration of consciousness and confusion. Brain magnetic resonance imaging (MRI) scan showed a mass-like enhancing lesion involving bilateral thalami, and biopsy revealed findings compatible with PACNS. The patient was treated with corticosteroids. Psychotic symptoms crystallized over the initial 2 months after the diagnosis and persisted for over a year. Severity of his symptoms improved with gradual normalization of the radiologic findings and antipsychotic medication.
  
  
  CONCLUSIONS
  Our case highlights the importance of considering PACNS as a differential diagnosis of a tumor-like mass lesion in the CNS and the significance of thalamic involvement in the pathogenesis of psychotic symptoms including delusions and hallucinations.
authors.affiliation: Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sangha
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: paulkim@skku.edu.
authors.forename: Doh Kwan
authors.initials: DK
authors.lastname: Kim
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000188:drug therapy / Q000209:etiology*; D013788:Thalamus / Q000473:pathology*; D020293:Vasculitis, Central Nervous System / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*
keywords: Central nervous system; Primary angiitis; Thalamus, Psychosis; Vasculitis