Granulomatosis with Polyangiitis Complicated by Hypertrophic Pachymeningitis Presenting with Simultaneous Multiple Intracerebral Hemorrhages
| Autor: | Tetsuji Sawada, Koichiro Tahara, Hiroaki Mori, Haeru Hayashi, Aki Shoji, Eri Kato |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Nausea Central nervous system Case Report Computed tomography macromolecular substances multiple intracerebral hemorrhages 03 medical and health sciences 0302 clinical medicine stomatognathic system Internal Medicine medicine Humans Sinus thrombosis Meningitis Cerebral Hemorrhage 030203 arthritis & rheumatology Intracerebral hemorrhage granulomatosis with polyangiitis medicine.diagnostic_test business.industry Hypertrophy General Medicine Middle Aged medicine.disease medicine.anatomical_structure pachymeningitis Angiography Vomiting Female Radiology medicine.symptom business Granulomatosis with polyangiitis 030217 neurology & neurosurgery |
| Zdroj: | Internal Medicine |
| ISSN: | 1349-7235 0918-2918 |
| DOI: | 10.2169/internalmedicine.9660-17 |
| Popis: | Central nervous system (CNS) involvement in granulomatosis with polyangiitis (GPA), including pachymeningitis and CNS vasculitis, is uncommon. Although intracerebral hemorrhage (ICH) has been reported in GPA, simultaneous multiple ICH (SMICH) is rare. We describe the case of a 50-year-old woman with a history of a limited form of GPA with chronic pachymeningitis who presented with acute-onset headache accompanied by nausea and vomiting, and who developed consciousness impairment. Computed tomography revealed bilateral subcortical ICH. Sinus thrombosis was not apparent on angiography. The patient was treated with high-dose corticosteroid therapy. The cause of the steroid-responsive SMICH in this case was unknown, but it might have been CNS vasculitis. Patients with GPA may present with SMICH, which is considered an indication for immunosuppressive therapy. |
| Databáze: | OpenAIRE |
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