Cerebral granulomatous angiitis associated with isolation of human T‐lymphotropic virus type III from the central nervous system

Yankner, Bruce A.; Skolnik, Paul R.; Shoukimas, Gregory M.; Gabuzda, Dana; Sobel, Raymond A.; Ho, David D.

doi:10.1002/ana.410200316

Cited by 157 publications

(40 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…16 Alternating segments of constriction and dilatation are sometimes seen in leptomeningitis and various cerebral vasculitides, 17 including the acquired immunodeficiency syndrome 18 and following herpes zoster ophthalmicus. 19 It has not been a feature in cases of pathologically proven primary granulomatous angiitis of the central nervous system 20 -32 because this latter process appears restricted to vessels of ^0.5 mm diameter that are not visualized with angiography.…”

Section: Discussionmentioning

confidence: 99%

Reversible cerebral segmental vasoconstriction.

Call

Fleming

Sealfon

et al. 1988

Stroke

402

247

View full text Add to dashboard Cite

Vessel constriction followed by dilatation is a postulated mechanism for migraine, although there is no definitive evidence for this.2 Aside from these two conditions, reversible constriction of arteries is not a recognized cause of cerebrovascular disease.We describe the clinical and angiographic syndrome of four patients with reversible constriction of the cerebral vasculature. We also review some of the relevant literature and discuss the nosology of this only recently recognized condition. Case Reports Case IA 48-year-old woman was admitted to the hospital because of a severe headache that was associated with a sense of spinning, nausea, vomiting, and blurred vision. Headaches were unusual for her, and there was no personal or family history of migraine.Initially, her blood pressure was 200/100 mm Hg, but it quickly fell to the 120/65 mm Hg range without

show abstract

Section: Discussionmentioning

confidence: 99%

Reversible cerebral segmental vasoconstriction.

Call

Fleming

Sealfon

et al. 1988

Stroke

402

247

View full text Add to dashboard Cite

show abstract

“…A vasculopathy mediated primarily by HIV was thought to be responsible in 6 of 14 cases of cerebral infarction in another autopsy study [6]. Other pathologic abnormalities observed in isolated cases such as eosinophilic [40], necrotizing [41]or granulomatous [42]vasculitis are of much less clear importance. A recent case report of isolated central nervous system angiitis in an HIV-infected patient includes a summary of all cases of HIV-infected patients with cerebral vasculitis not associated with infectious or tumoral processes published in the literature (22 cases in total) [43].…”

Section: New Insights Into the Mechanisms Of Stroke In Hiv-infected Pmentioning

confidence: 99%

Stroke in HIV-Infected Patients: A Clinical Perspective

Rabinstein¹

2003

Cerebrovasc Dis

View full text Add to dashboard Cite

The occurrence of stroke in patients with human immunodeficiency virus (HIV) infection has been traditionally associated with opportunistic infections and tumors, and advanced stages of immunosuppression. However, this reality is undergoing major changes. Effective antiretroviral regimens are now able to forestall the progression of HIV infection and avoid early mortality. As HIV-infected patients are growing older, clinicians are facing new challenges, including an increasing incidence of vascular complications. The use of protease inhibitors is associated with a variety of metabolic derangements that could produce accelerated atherosclerosis. Cerebrovascular hemodynamic function is impaired in HIV-infected patients with evidence of abnormal vasoreactivity even in otherwise healthy individuals. The potential contribution from these novel mechanisms should be added to the high incidence of classic vascular risk factors in the HIV-infected population and the cardiac abnormalities frequently observed in these patients. Large-scale epidemiological studies should be carried out to define the true incidence of stroke in HIV-infected patients and the factors associated with its occurrence.

show abstract

“…Isolated angiitis of the CNS has been now defined as an acquired clinical disease characterized by CNS dysfunction that remains unexplained following thorough clinical, laboratory, and neurologic investiga tions; appears to be unassociated with systemic illness, Arteritis associated with auto-immune disease Rheumatoid arthritis (12] Systemic lupus erythematosus [13] Scleroderma [ 14] Sjogren's syndrome [15] Ulcerative colitis [16] Coeliac disease (17] Arteritis associated with infectious disease Herpes zoster (18)(19)(20) Cytomegalovirus infection [2I| Human immunodeficiency virus infection [22] Fungal infections [23] Syphilis [24] Borrelia burgdorferi [25] Tuberculosis (26) Bacterial meningitis [27] Acute bacterial endocarditis [28] Strongyhides siercoralis infection [29] Relapsing polychondritis [30] Arteritis associated with neoplasia Hodgkin's and non-Hodgkin's lymphoma [31. 32] Neoplastic angio-endotheliosis [33] Malignant histiocytosis [34] Hairy cell leukaemia [35] Arteritis associated with toxicity Drugs [36][37][38][39][40] Sympathomimetic agents [36][37][38][39] Irradiation [41] and yields evidence by cerebral angiography or biopsy of CNS tissues of a vasculitis confined to the CNS [42].…”

Section: History /Terminologymentioning

confidence: 99%

Isolated Angiitis/Angiopathy of the Central Nervous System

Hankey¹

1990

Cerebrovasc Dis

View full text Add to dashboard Cite

One hundred cases of isolated angiopathy of the central nervous system (CNS) have been described, the majority of whom (71%) were diagnosed histologically. The pathological findings were those of angiitis, most frequently granulomatous angiitis. These patients should be classified as isolated angiitis of the CNS. The minority of patients (29%) were diagnosed according to clinical and angiographic findings which lack sensitivity and specificity. They represent a heterogeneous group, comprising several cases of probable isolated angiitis of the CNS, some clinical and angiographic syndromes associated with acute hypertension, subarachnoid haemorrhage or migraine and other more obscure ''entities'' such as post-partum cerebral angiopathy and isolated benign cerebral angiopathy. In the absence of a histological diagnosis, it is preferable to classify them as isolated angiopathy of the CNS. Although isolated angiitis of the CNS can be considered a discrete, or at least definable, subset of isolated angiopathy of the CNS, it is unclear whether it is a specific disorder or part of a spectrum of disease or even one of a number of reactions to various antigens. The finding of granulomatous angiitis of the CNS (GACNS) in several patients with various systemic disorders suggests that GACNS may be a non-specific pathological reaction. Until the last decade, the prognosis of isolated angiitis of the CNS was extremely poor. Most patients now survive and return to active lives. The major influence on outcome appears to have been the use of combination corticosteroid and cyclophosphamide therapy, although no randomized controlled trials have been undertaken. Before prolonged treatment with such potent medication is prescribed, it recommended that other causes of CNS vasculitis be carefully excluded and the diagnosis of isolated angiitis of the CNS be established histologically by combined leptomeningeal and parenchymal biopsy. The risks of biopsy would not appear to exceed those of untreated isolated angiitis of the CNS. Multicentre collaboration of interested groups should be encouraged if controlled therapeutic trials are to be achieved.

show abstract

Cerebral granulomatous angiitis associated with isolation of human T‐lymphotropic virus type III from the central nervous system

Cited by 157 publications

References 10 publications

Reversible cerebral segmental vasoconstriction.

Reversible cerebral segmental vasoconstriction.

Stroke in HIV-Infected Patients: A Clinical Perspective

Isolated Angiitis/Angiopathy of the Central Nervous System

Contact Info

Product

Resources

About