|
|
|
Click Here to return To Results
|
|
Isolated angiitis of the central nervous system(IAC)is usually a fatal inflammatory disease with a predilection for small blood vessels.Recurrent cerebral infarction leading to death within a few years is the usual course,but this may be significantly altered by aggressive immunosuppressive therapy with prednisone and cyclophosphamide.Other diseases may,however,present with similar clinical and angiographic features.Because antemortem diagnosis suggests a therapy,establishing the criteria for diagnosis is important.This report describes clinical, angiographic,and biopsy features,and therapy of five successfully treated patients with IAC.The following specific criteria are recommended for establishing an antemortem diagnosis of IAC:(1)clinical pattern of headaches and multifocal neurologic deficits present for at least 6 months,unless the deficits are severe at onset or rapidly progressive;(2) cerebral angiography demonstrating segmental arterial narrowing;(3) exclusion of systemic inflammation or infection;and(4)leptomeningeal/ parenchymal biopsy demonstrating vascular inflammation or exclusion of alternate diagnoses.Based upon the successful management of these five previously unreported patients,as well as others in the literature,the following treatment regimens are recommended for the initial 6 weeks of therapy:(1)prednisone 40 to 60 mg/day,and(2)cyclophosphamide 100 mg/day. |
|
(click to filter results - removes previous filter)
angiitis,isolated of CNS angiography,cerebral brain biopsy cerebrovascular accident cerebrovascular accident,recurrent cyclophosphamide headache headache,severe immunosuppressive agents meningeal biopsy neuropathology prognosis review article steroid therapy,CNS treatment and complications with treatment of neurologic disorder
|
Click Here to return To Results
|
|