Possible primary central nervous system vasculitis presentıng with confusion and hallucination: a case

Year 2020, Volume: 11 Issue: 3, 203 - 206, 22.06.2020

Türkan Acar Sena Boncuk Bilgehan Atılgan Acar Murat Alemdar Yeşim Güzey Aras

https://doi.org/10.18663/tjcl.672580

Abstract

Primary central nervous system vasculitis (PCNSV) is a rare inflammatory disease of the vessels of the brain and spinal cord without signs of systemic vasculitis. Due to the difficulty of diagnosis, it is difficult to determine the exact incidence. Clinical findings may include a wide variety of neurodeficides and are subacute-chronic. The biopsy or cerebral angiography recommended for definitive diagnosis does not have as high specificity as expected. The presence of a prodromal clinic, the presence of neurodeficitis, the elimination of systemic findings, the presence of atypical lesions on MRI, and abnormal CSF analysis can also lead to a diagnosis of PSSSV. Immunosuppressive agents such as steroids and cyclophosphamide are used in the treatment. In this article, we present a case with abnormal CSF findings and a diagnosis of possible PSSSV using MR spectroscopy.

Keywords

vasculitis, confusion, central nervous system

Konfüzyon ve halüsinasyon ile prezente olan olası primer santral sinir sistemi vasküliti: bir olgu

Abstract

Primer santral sinir sistemi vasküliti (PSSSV), sistemik vaskülit belirtisi olmadan beyin ve omurilikteki damarlarının nadir bir inflamatuar hastalığıdır. Tanı zorluğu nedeniyle tam insidansını belirlemek zordur. Klinik geniş nörodefisitler içerebildiği gibi subakut-kronik seyirlidir. Kesin tanı için önerilen biyopsi veya serebral anjiografinin beklendiği kadar yüksek özgüllüğü yoktur. Prodromal bir kliniğin bulunması, nörodefisit varlığı, sistemik bulguların ekartasyonu, MRG’de atipik lezyonların varlığı, anormal BOS analizi ile de olası PSSSV tanısına ulaşılabilir. Tedavide steroid ve siklofosfamid gibi immunsüpresif ajanlar kullanılmaktadır. Bu yazıda anormal BOS bulgularının olduğu ve MR spectroskopiden faydalanılarak olası PSSSV tanısı alan olgu sunulmuştur.

Keywords

vaskülit, konfüzyon, santral sinir sistemi

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