This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

An Inflammatory Reaction of Diverse Etiology

David S. Younger, MD; Arthur P. Hays, MD; John C. M. Brust, MD; Lewis P. Rowland, MD

Arch Neurol. 1988;45(5):514-518.

Abstract
• Granulomatous angiitis of the brain (GAB) is defined histologically by granulomatous inflammation of intracranial blood vessels. We have studied four patients with autopsy-proved GAB who had, respectively, Hodgkin's lymphoma, herpes zoster, neurosarcoidosis, and no associated illness. Headache, fever, or mental change was followed by hemiparesis or quadriparesis, coma, and death in all four patients. There were no diagnostic findings from cerebral computed tomograms, cerebrospinal fluid, or cerebral angiograms; the diagnosis was established only by postmortem examination. Vasculitis was limited to the brain in all four patients, and involved large arteries, small arteries and veins, or both large and small vessels. Differences in etiology and different particulars of the pathologic conditions imply that GAB is a nonspecific reaction, not a unique disease. The diagnosis, moreover, cannot be proved without histologic confirmation. A biopsy specimen is the only way to ascertain the diagnosis in living patients.

Author Affiliations
From the Departments of Neurology (Drs Younger, Brust, and Rowland) and Pathology (Division of Neuropathology) (Dr Hays), Columbia University College of Physicians and Surgeons, and the Neurology Service of the Neurological Institute and the Department of Pathology (Division of Neuropathology), Presbyterian Hospital, Columbia-Presbyterian Medical Center, and the Department of Neurology, Harlem Hospital Medical Center, New York.

Footnotes
Accepted for publication Oct 13, 1987.

Reprint requests to Neurological Institute of New York, Columbia-Presbyterian Medical Center, NI 13, New York, NY 10032 (Dr Younger).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Primary CNS vasculitis with spinal cord involvement
Salvarani et al.
Neurology 2008;70:2394-2400.
ABSTRACT | FULL TEXT  

Neurosarcoidosis Presenting as Acute Infarction on Diffusion-Weighted MR Imaging: Summary of Radiologic Findings
Hodge et al.
Am. J. Neuroradiol. 2007;28:84-86.
ABSTRACT | FULL TEXT  

Primary Angiitis of the Central Nervous System at Conventional Angiography
Kadkhodayan et al.
Radiology 2004;233:878-882.
ABSTRACT | FULL TEXT  

Imaging Manifestations of Neurosarcoidosis
Smith et al.
Am. J. Roentgenol. 2004;182:289-295.
FULL TEXT  

Spinal Cord Involvement in Primary Angiitis of the Central Nervous System: A Report of Two Cases
Campi et al.
Am. J. Neuroradiol. 2001;22:577-582.
ABSTRACT | FULL TEXT  

Perfusion and Diffusion Imaging: A Potential Tool for Improved Diagnosis of CNS Vasculitis
Yuh et al.
Am. J. Neuroradiol. 1998;20:87-89.
FULL TEXT  

Immune Reactions Associated With Cerebral Amyloid Angiopathy
Yamada et al.
Stroke 1996;27:1155-1162.
ABSTRACT | FULL TEXT  

Idiopathic Granulomatous Angiitis of the Central Nervous System: Diagnostic Challenges
Vollmer et al.
Arch Neurol 1993;50:925-930.
ABSTRACT