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Query: UMLS:C0042384 (vasculitis)
 20,525 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The involvement of the central nervous system (CNS) by a vasculitic process is an infrequent but serious manifestation of several systemic diseases. The neurological disturbances are most often due to cerebral ischemia; however, vascular inflammation is not the only pathogenetic factor of CNS disease in systemic vasculitis. Most often, the specific diagnosis of CNS vasculitis depends on identifying clinical or histologic evidence of target organ involvement outside the CNS. The primary angiitis of the central nervous system (PACNS) is a rare form of vasculitis limited to the central nervous system. The diagnosis of this disorder is difficult owing to its various clinical manifestations and to the poor specificity of the neurological investigations. The demonstration by cerebral angiography and/or tissue examination of an arteritic process is mandatory for establishing this diagnosis.
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PMID:[Vasculitis of the central nervous system]. 154 57

An overview is given over etiology and prognosis of cerebral ischemias until the age of 40. In a time period of 19 years, 168 patients were diagnosed with cerebral ischemia until the age of 40 (91 females, 77 males). The most frequent etiology is premature atherosclerosis in patients with vascular risk factors (up to 50%). Cardiogenic embolism is responsible for 1 to 34% of the cases: cardiac valve diseases and endocarditis being the most frequent sources. In 2 to 19% a vasculitis is diagnosed. While infectious arteritis is especially frequent in countries of the third world, immunovasculitides are common in Europe and the USA. Noninflammatory vasculopathies include spontaneous or traumatic dissection, fibromuscular dysplasia and vascular malformations. A migrainous stroke is especially frequent in female smokers with intake of oral contraceptives. During pregnancy both sinus thrombosis and arterial ischemia occur. Hematologic causes for ischemia are polycythemia, thrombocytosis and genetic diseases (sickle cell anemia, AT3-deficiency). Cerebral ischemia may occur in connection with the ingestion of ergot-derivates. The prognosis of cerebral ischemia in young adults is better than in older stroke-patients.
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PMID:[Cerebral ischemia in young adults]. 193 40

Lupus anticoagulants and anticardiolipin antibodies are antiphospholipid antibodies (APLAb) with related antigenic specificities and are newly recognized markers for an increased risk of thrombosis. We studied 48 patients who presented with cerebral or visual dysfunction associated with APLAb to help clarify the diagnostic, clinical, laboratory, radiologic, and pathologic features in these patients. Most patients presented with transient cerebral ischemia or cerebral infarction. Recurrent and stereotypic events were frequent. Visual disturbances resulted from amaurosis fugax, retinal arterial or venous occlusion, occipital ischemia, diplopia, and migraine-like disturbances. Three patients presented with severe atypical classic migraine. Recurrent infarcts of brain and eye were significantly associated with the presence of cigarette smoking, hyperlipidemia, and a positive antinuclear antibody. During 44.4 patient-years of prospective follow-up, the combined stroke and systemic thrombotic event rate was 0.27 events per patient-year and was 0.54 events per patient-year if TIA and death were included. Forty (83%) of the patients did not have systemic lupus erythematosus (SLE). Thrombocytopenia was present in 15 (31%) and a false-positive VDRL in 11 (23%) of the patients. Cerebral angiography was normal or revealed large-vessel occlusion or stenosis without changes suggestive of vasculitis. Patients with only transient dysfunction generally had normal radiologic studies, including angiography. Organs and arterial vessels studied pathologically revealed thrombotic occlusive disease without vasculitis. APLAb are strongly associated with an immune-mediated thrombotic tendency, generally in the absence of SLE. Other stroke risk factors may add to the risk of recurrent ischemic events in patients with APLAb.
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PMID:Cerebrovascular and neurologic disease associated with antiphospholipid antibodies: 48 cases. 238 25

We report on 10 patients suffering from cerebral ischemic episodes in whom mitral valve prolapse was diagnosed. Neurologic assessment included computerized tomography and angiographic study. In one case, the angiographic study revealed the presence of intracranial vasculitis and one woman was taking the contraceptive pill. The diagnosis of mitral valve prolapse was established on the basis of clinical grounds and electrocardiographic, Doppler study, Holter monitoring and two-dimensional echocardiographic signs. Our findings confirm that mitral valve prolapse is an etiologic factor to be considered in young adults with cerebral ischemia, although mitral valve prolapse does not exclude the possibility of other etiopathogenic conditions occurring.
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PMID:[Mitral valve prolapse and cerebral ischemia]. 262 81

A patient with widespread livedo reticularis and transient cerebral ischaemia (Sneddon's syndrome) is described. She also had painful scarring ulcers of the lower legs resembling livedo vasculitis and a circulating anticardiolipin antibody. We suggest that Sneddon's syndrome and livedo vasculitis may be pathogenetically related.
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PMID:Sneddon's syndrome (livedo reticularis and cerebral thrombosis) with livedo vasculitis and anticardiolipin antibodies. 229 99

We retrospectively and prospectively reviewed the incidence of stroke in 105 patients with systemic lupus erythematosus (SLE). Stroke occurred in 14 (15%) of 91 consecutive patients with documented SLE; nine (64%) of the 14 had multiple cerebral infarcts. Factors associated with stroke and the frequency of stroke were systemic thrombosis (30%), elevated partial thromboplastin time (36%), spontaneous abortion (50%), age over 60 years (57%), transient ischemic attacks (57%), previous stroke (64%), and cardiac valvular disease (86%). The major period of risk for the first stroke was during the first 5 years of SLE. The most frequent etiology was a cardiogenic embolus or an antibody-mediated hypercoagulable state, with cerebral vasculitis occurring only in association with infection. Because of the decreased fibrinolysis seen in patients with SLE, anticoagulant therapy may be the most effective preventive treatment currently available. Anticoagulant therapy seemed to prevent recurrent focal cerebral ischemia in our patients and was associated with relatively few and minor complications. Patients with a history of transient ischemic attacks or cardiac valvular lesions are at high (57% and 87%, respectively) risk of stroke. Patients who have had a stroke are at high (64%) risk for a recurrent stroke. Anticoagulant therapy is recommended for all of these patients.
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PMID:Frequency, etiology, and prevention of stroke in patients with systemic lupus erythematosus. 230 Sep 86

Hypoplasia of the carotid arteries is a rare congenital anomaly which when clinically symptomatic presents as cerebral ischemia or hemorrhage. Patients with this anomaly commonly have associated variations of the circle of Willis, an increased incidence of intracranial aneurysms and extensive networks of collateral vessels to accommodate the diminished carotid flow. Carotid artery hypoplasia should not be confused with other conditions which may have a similar appearance such as arterial dissection, vasculitis, and tubular fibromuscular hyperplasia.
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PMID:Internal carotid artery hypoplasia. 354 68

A retrospective study was conducted on a young adults population affected by permanent symptoms of cerebral focal ischemia. Within 6 years, 24 patients between the ages of twenty and fifty were admitted to the Neurological and Medical department of our Hospital because of cerebral ischemic stroke. In 7 (29.2%) there was a previous history of common or classic migraine. No patients suffered headache at the time of neurologic deficit onset. In the other 17 patients in the study, 6 (25%) had valvular heart disease, 2 (8.3%) had signs suggestive of vasculitis, 2 (8.3%) had a story of head and neck injury, and in the remaining 7 (29.2%) patients no discernible etiology was demonstrated. Our data confirm the hypothesis that migraine may be considered an etiologic factor for persistent cerebral ischemia in young adults.
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PMID:[Hemicrania and cerebral ischemia in young adults]. 377 93

A 39 year old white man, with advanced Virchowian hanseniasis died with signs of extensive meningeal involvement. His medical background showed repeated episodes of Erythema nodosum hansenicum (ENH) in the last three years of his life, besides ischemic gangrena with amputation of the left leg and cerebral vascular ischemic attacks. The autopsy revealed an advanced stage of arteriosclerosis affecting mainly the brain and the distal segment of the aorta and its ramifications. A propagating thrombus was found along the left femoral and iliac arteries and in the terminal portion of the aorta extending to the renal arteries. Thrombosis was also found along the left femoral vein, left iliac vein and distal segment of the inferior cava. The brain showed anemic infarction in organization and a generalized meningoencephalic involvement with granulomatous reaction caused by Cryptococcus neoformans. It was suggested a possible relationship between Erythema nodosum reactions and thrombosis phenomena. Torulosis was considered as a final occurrence and the proliferative vasculitis due to the granulomatous process in the sub-arachnoidal space has certainly aggravated the cerebral ischemia.
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PMID:[Cryptococcus neoformans meningoencephalitis as a complication of arteriosclerotic vascular insufficiency in Virchowian leprosy]. 734 2

A cohort of 8 patients with myxoma of the left atria and neurological manifestations is reported. Cerebral ischaemia, sometimes responsible for epileptic seizures, led to the discover of the myxoma (5 cases) or recurrence after exeresis (1 case) with imaging evidence of cerebral infarction in 5 cases. The first manifestation was a retinal embolism and temporary ischaemia in 1 case and pulmonary embolism with regressive cerebral ischaemia in another case with bilateral myxoma. Some clinical particularities should be underlined including exercise-induced neurological defect (3 cases), systemic embolism associated with cerebral infarction (3 cases), migraine headache as the initial manifestation (1 case) preceding by a pseudolupic syndrome suggesting the possibility of cerebral vasculitis or infectious endocarditis (1 case). The prognosis depends on the risk of recurrent atrial tumour formation (1 case). Metastases are rare. Multiple cerebral aneurysms (3 cases) did not lead to haemorrhagic complications.
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PMID:[Myxoma of the left atrium with neurologic manifestations: 8 cases]. 759 71


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