Primary central nervous system vasculitis (PCNSV) is a rare and complex disease that poses formidable diagnostic and therapeutic challenges. Since its initial recognition as a distinct clinical entity in the 1950s, there has been considerable advancement in our understanding of PCNSV histopathology, specific clinical subsets, and their response to treatment. However, PCNSV is one of the rarest vasculitides, and still remains a challenging diagnosis with many unanswered questions regarding optimal management. In this review, we intend to provide a detailed outline of approaches that are currently being employed for the treatment of PCNSV. We exhaustively review available cohort series of PCNSV and critically appraise the data for study definitions, treatment approaches, and predictors of treatment outcomes. Finally, we also propose a treatment approach for PCNSV.
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http://dx.doi.org/10.2147/VHRM.S488202 | DOI Listing |
Cureus
October 2024
Department of Pediatrics, Okinawa Prefectural Miyako Hospital, Miyako, JPN.
In children, the causes of cerebral infarction are varied, and accurate diagnosis and treatment are imperative. An early school-age boy was brought to our hospital due to seizures and impaired consciousness. He was diagnosed with cerebral infarction due to primary central nervous system vasculitis (PCNSV) based on increased inflammatory response and circumferential vessel wall thickening in his right middle cerebral artery.
View Article and Find Full Text PDFIntern Med
November 2024
Department of Neurology, Saitama Medical Center, Saitama Medical University, Japan.
A 75-year-old man presented with cognitive decline, headaches, and ataxic gait. Magnetic resonance imaging (MRI) revealed acute infarcts in multiple brain regions, and vessel wall MRI (VW-MRI) demonstrated concentric arterial wall thickening and enhancement in some intracranial arteries, initially suggesting primary central nervous system vasculitis (PCNSV). Despite immunosuppressive therapy, the patient developed further infarction.
View Article and Find Full Text PDFVasc Health Risk Manag
October 2024
Department of Neuro-Interventional Surgery, Neurological Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
Primary central nervous system vasculitis (PCNSV) is a rare and complex disease that poses formidable diagnostic and therapeutic challenges. Since its initial recognition as a distinct clinical entity in the 1950s, there has been considerable advancement in our understanding of PCNSV histopathology, specific clinical subsets, and their response to treatment. However, PCNSV is one of the rarest vasculitides, and still remains a challenging diagnosis with many unanswered questions regarding optimal management.
View Article and Find Full Text PDFNeurology
October 2024
From the Departments of Clinical Neurosciences (J.I.R., R.K.) and Pathology and Laboratory Medicine (D.N.), and the Hotchkiss Brain Institute (J.I.R.), University of Calgary, Alberta, Canada; Neuroimmunology Centre, Department of Neurology (J.I.R.), Royal Melbourne Hospital; and Clinical Outcomes Research Unit, Department of Medicine (J.I.R.), University of Melbourne, Australia.
Primary CNS vasculitis (PCNSV) is uncommonly considered in the differential diagnosis of tumor-like lesions. This case report of tumefactive PCNSV highlights imaging features that should increase clinical suspicion for CNS vasculitis, potentially lending to earlier diagnosis and treatment. A 62-year-old man presented with a 1-month history of focal motor seizures and cortical sensory loss localizing to the right frontoparietal lobe.
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