Cerebral Angiography in Vasculitis Affecting the Nervous System

Abstract

Of 199 patients with clinico-laboratory evidence of vasculitis, 42 were submitted to cerebral angiography; 35 angiograms were abnormal, but only 21 were characteristic of the particular disease process. A pattern consistent with vasculitis diagnosed in 19 angiograms, was due to neoplasm in 4 and neurofibromatosis, DXT and amphetamines each in 1 case. Moya-Moya type collaterals shown in 20 angiograms were due to the idiopathic disease in 10 but due to non-inflammatory pathologies in 7. Fibromuscular dysplasia shown in 28 angiograms was an incidental finding in 20 of these. Of 56 cerebral angiograms for ischaemic stroke in patients under 15 years old, 17 were normal and only 8 vascular lesions were likely to have been of inflammatory origin. In routine clinical practice cerebral angiography, though essential in the management of mycotic aneurysm and in the diagnosis of Moya-Moya disease isolated vasculitis and fibromuscular dysplasia, plays only a limited role in the diagnosis of other types of vasculitis.

Connective Tissue Diseases, Vasculitis, and the Nervous System

“…113,114 Focal brain hemorrhage may occur. 116 Unfortunately, these fi ndings are neither sensitive nor specifi c. 107 Therefore, the diagnosis of PACNS is defi nite only when confi rmed pathologically. 115 Cerebral angiographic fi ndings of vasculitis are multifocal vessel narrowing, poststenotic dilatations, and focal variations of blood fl ow, usually involving multiple vessels.…”

Coexisting moyamoya syndrome and type 1 diabetes mellitus: A case report and review of the literature

“…[6] Recent reports have described associations with various autoimmune disorders. [7][8][9][10] Diffuse hyperplasia of the smooth muscle cells occurs in the affected arteries, without any atherosclerotic or inflammatory changes. [11] We present the clinical, imaging, cerebral hemodynamic features and management approach in a patient with type 1 diabetes mellitus (DM), alopecia areata, and MMD along with a review of the available literature.…”