Cerebral Vasculitis

Central nervous system (CNS) abnormalities are common in vasculitic and rheumatologic syndromes. The underlying diagnosis can usually be made on the basis of the associated clinical and laboratory findings; the CNS findings are usually not pathognomonic or unique. Occasionally, however, there is no apparent underlying systemic disease in a patient with only neurologic complaints. In this circumstance, the clinician must differentiate between the isolated neurologic presentation of a (then clinically silent) systemic inflammatory disease and an isolated CNS process, which could be a vasculitis affecting only the CNS. The systemic necrotizing vasculitides and their CNS manifestations have been reviewed. Siva , Rehman, Rhodes et al. , and Scolding and colleagueshave each written recent reviews of vasculitis of the nervous system, both primary and secondary.

Cerebral vasculitis is a serious but uncommon condition which presents considerable difficulties in recognition, diagnosis and treatment. Cerebritis, defined as focal inflammation of the brain parenchyma and spinal cord, can be an idiopathic disorder or can be secondary to toxins, infections, neoplasms or part of a systemic autoimmune disease. Bacterial organisms are often found in cerebritis associated with CNS lesions involving septic thromboemboli, tumors, ruptured vascular malformation, infarcts, and CNS trauma. Streptococci or staphylococci are most often noted; less common bacterial agents include Gram-negative organisms such as Escherichia coli , pseudomonas and Haemophilus influenzae .Cerebral vasculitis is a rare cause of stroke

The diagnostic value of four investigative procedures not previously studied in cerebral vasculitis was assessed: ophthalmological examination using low-dose fluorescein angiography with slit-lamp video microscopy of the anterior segment (abnormal in 4/5 patients); spinal fluid oligoclonal band analysis (abnormal in 3/6 patients); anti-neutrophil cytoplasmic antibody assay (abnormal in 3/8 patients); and indium-labelled white-cell cerebral imaging (positive in only one patient).The most common parasitic CNS infection is neurocysticercosis. The majority of such individuals present with seizures. Granulomatous cerebral vascultitis is a granulomatous vasculitis of the small arteries of the brain.

Cause of Cerebral Vasculitis

The possible causes other than cocaine produced no results. We now include cocaine with methamphetamines, heroin, and ephedrine as illicit drugs that can cause cerebral vasculitis.

Symptoms of Cerebral Vasculitis

The most common sympoms of Cerebral Vasculitis:

• Migraine headaches
• Seizures
• And psychosis, as well as focal neurological signs.

Treatment of Cerebral Vasculitis

Treatment of Cerebral Vasculitis:

• Cerebral Vasculitis is postulated that B. burgdorferi -specific IgM antibodies cross-react with human axons leading to the development of neurologic lesions.
• A hallmark of neuroborreliosis is CSF lymphocytic pleocytosis.
• A biopsy is not necessary to diagnose Lyme disease of the CNS; serological tests with indirect immunofluorescence or enzyme immunoassay for the organism is usually sufficient.
• The best technique is Borrelia -specific DNA detection using PCR.
• A colorimetric microplate hybridization assay using PCR amplified DNA fragments sandwiched between two probes is a promising, rapid system for diagnostic analysis of specimens from clinically suspected Lyme disease patients.

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