Angiitis And Central Nervous System Involvement

ObjectiveAngiitis refers to the pathologic process that the vessal walls inflame and necrosis. It can invade any organ including nervous system to cause dysfunction. The nervous system injures conclude periphery nervous system damage and central nervous system damage. Clinical and pathologic characteristics of 12 central nervous system injure of angiitis were retrospetively reviewed,inhancing to know this kind of diseases.Material and methodsAll of the 12 angiitis patients are 2008-2010 in our nerve section ward,including 3 primary angiitis of central nervous system patients.Among systemic vasculltis, there are 3 Takayasu'S arteritis patients. Among connective tissue disease, there are 4 primary Sjogren's syndrome patients, there are 2 Behcet's disease patients.Routine laboratory check,examination of cerebrospinal fluid and autoantibody examination were done.All sufferers had skull MRI check, among them,7 patients had angiography:magnetic resonance angiography(MRA),computer tabulation angiography (CTA) or Digital subtraction angiography(DSA).2 patients had brain tissue biopsy.ResultClinical presentation:Among 12 patients,there are male 2, female 10。Acute attack is 9,subac is 3.Initial symptom:headache 5(41.67%),a side limbs inability 3(25%), and eleptiform attack,lalopathy,swallow bucking,see misty,walk unsteadyly. Clinical symptom: headache 7, a side limbs inability 7,fever 5, cognize function decrease 4,see misty 4, lalopathy,swallow bucking 3, and walk unsteadyly,eleptiform attack,transient ischemic attack,transient unconsciou-sness,have muscular spasms,eye sport obstacle. Imaging manisfectition:Skull MRI normal 1, involves in brain hemisphere 6(50%), involves in brain stem 2(16.67%), involve in hypophysis 1(8.33%), brain hemisphere and brain stem all involved 2(16.67%).Double the sides damage is 6(50%), one side damage is 5(41.67%)。Among the 7 angiography (MRA, CTA or DSA),3 is normal(42.86%), the rest abnormality is 4(57.14%):1 MRA showes inside artery walks stiffly, and irregularly narrow and obliterate.1 MRA showes inside artery is small and stiff, cent decrease; 1 showes one side of internal carotid artery inside develop poor。1 MRA showes both sides of front, medium, empress artery branch rarely seen, walks stiffly,and the signal is abnormal.Pathology result:2 sufferers have brain tissue check,1 shows piamater,cortex and small artery wall under cortex and periangiitis。1 shows inflammatory cells infiltrate in hypophysis.ConclusionClinical performance of angiitis to the central nervous system system injure is diverse,.General laboratory parameter lack sensitivity and particularity.Skull MRI and MRA have certain help to diagnosis, but lack particularity.The DSA is the relatively sensitive check method.Diagnosis of the gold standard is brain tissue biopsy.