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Cerebral Vasculitis - Case 2

A 55 year-old woman presented with headaches followed by a series of strokes over 3 weeks.

Magnify the Dotted Area to See the "Beaded" Vessels

Cerebral Vasculitis: Cerebral Angiogram, Left Internal Carotid Artery injection, lateral view, with expanded view of the dotted area. Normally, arteries taper as they travel distally. However, upon close inspection of the distal branches, note the beaded appearance of the vessels. This appearance is consistent with cerebral vasculitis, which can occur as an isolated syndrome or as part of a more widespread systemic vasculitis. Often, brain and meningeal biopsy are needed to confirm the diagnosis. Cerebral vasculitis often presents as an encephalopathy with superimposed focal deficits from multiple ischemic strokes. The syndrome can be confused with embolic infarctions and atherosclerotic intracranial disease. The latter is more prominent in individuals of Asian and African American descent compared to Caucasians.

Revised 11/30/06
Copyrighted 2006. David C Preston