title: Spinal cord hemorrhage in a patient with neurosarcoidosis on long-term corticosteroid therapy: case report.
abstract: BACKGROUND
  Central nervous system bleeding is a rare complication of neurosarcoidosis: only 18 cases of spontaneous cerebral hematoma have been reported. We present the first recorded case of spinal cord hemorrhage in neurosarcoidosis.
  
  
  METHODS
  A 48-year-old Caucasian woman had relapsing neurosarcoidosis for 5 years, with inflammatory spinal and cerebral lesions. While on 20 mg corticosteroids, she experienced subacute paraparesia with right leg pain. A spine MRI revealed a low thoracic hematomyelia at the T10-T11 level. Despite high doses of corticosteroids, her condition continued to worsen. Surgical evacuation of the hematoma was performed 10 days after the onset of bleeding, and she partially recovered.
  
  
  CONCLUSIONS
  This report highlights the possibility of spinal cord hemorrhage secondary to sarcoid vasculitis. The patient improved after surgical evacuation of the intramedullary hematoma. Immuno-modulating agents must be envisaged in severe neurosarcoidosis, to prevent complications.
authors.affiliation: Department of Neurology, Pontchaillou Hospital, Rennes University Hospital, Rennes, France. benoit.pegat@gmail.com.
authors.forename: Benoit
authors.initials: B
authors.lastname: Pegat
authors.affiliation: Department of Neurology, Pontchaillou Hospital, Rennes University Hospital, Rennes, France. sophie.drapier@chu-rennes.fr.
authors.forename: Sophie
authors.initials: S
authors.lastname: Drapier
authors.affiliation: Department of Neurosurgery, Pontchaillou Hospital, Rennes University Hospital, Rennes, France. xavier.morandi@chu-rennes.fr.
authors.forename: Xavier
authors.initials: X
authors.lastname: Morandi
authors.affiliation: Department of Neurology, Pontchaillou Hospital, Rennes University Hospital, Rennes, France. gilles.edan@chu-rennes.fr.
authors.forename: Gilles
authors.initials: G
authors.lastname: Edan
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D002493:Central Nervous System Diseases / Q000150:complications* / Q000473:pathology; D005260:Female; D006406:Hematoma / Q000473:pathology / Q000601:surgery*; D006470:Hemorrhage / Q000150:complications* / Q000473:pathology; D006801:Humans; D007249:Inflammation; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012507:Sarcoidosis / Q000150:complications* / Q000473:pathology; D013116:Spinal Cord / Q000473:pathology*; D016896:Treatment Outcome; D014657:Vasculitis / Q000150:complications / Q000473:pathology
chemical_list: D000305:Adrenal Cortex Hormones