Successful emergent angioplasty of neurosarcoid vasculitis presenting with strokes

Sarcoidosis is a systemic disease with neurologic involvement in approximately 5% of cases. Ischemic events related to neurosarcoid vasculitis are rare. We report the successful treatment of symptomatic neurosarcoid vasculitis with angioplasty. A 41-year-old African American with a diagnosis of neur...

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Bibliographic Details
Published in:Surgical neurology 2006-10, Vol.66 (4), p.402-404
Main Authors: Brisman, Jonathan L., Hinduja, Archana, McKinney, James S., Gerhardstein, Brian
Format: Article
Language:English
Subjects:
Adult
Angioplasty
Angioplasty, Balloon - instrumentation
Angioplasty, Balloon - methods
Angioplasty, Balloon - trends
Anterior Cerebral Artery - diagnostic imaging
Anterior Cerebral Artery - pathology
Anterior Cerebral Artery - surgery
Anticoagulants - therapeutic use
Antihypertensive Agents - therapeutic use
Aphasia - etiology
Aphasia - physiopathology
Aphasia - surgery
Basilar Artery - diagnostic imaging
Basilar Artery - pathology
Basilar Artery - surgery
Biological and medical sciences
Brain - blood supply
Brain - pathology
Brain - physiopathology
Cerebral Angiography
Disease Progression
Endovascular
Humans
Magnetic Resonance Imaging
Male
Medical sciences
Middle Cerebral Artery - diagnostic imaging
Middle Cerebral Artery - pathology
Middle Cerebral Artery - surgery
Neurosarcoid
Neurosurgery
Paresis - etiology
Paresis - physiopathology
Paresis - surgery
Sarcoidosis - complications
Sarcoidosis - physiopathology
Stroke
Stroke - etiology
Stroke - physiopathology
Stroke - surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Treatment Outcome
Vasculitis
Vasculitis, Central Nervous System - etiology
Vasculitis, Central Nervous System - physiopathology
Vasculitis, Central Nervous System - surgery
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Description
Summary:Sarcoidosis is a systemic disease with neurologic involvement in approximately 5% of cases. Ischemic events related to neurosarcoid vasculitis are rare. We report the successful treatment of symptomatic neurosarcoid vasculitis with angioplasty. A 41-year-old African American with a diagnosis of neurosarcoid presented with aphasia and right-sided weakness. He was treated medically with antiplatelet agents, heparinization, and hypertensive therapy. Despite this treatment, he experienced clinical worsening and radiographic extension of his infarcts. He underwent successful angioplasty of a severe focal stenosis of the left middle cerebral artery. After the procedure, he experienced marked improvement in his symptoms and at follow-up continues to improve. We report the angiographic demonstration of neurosarcoidosis with large vessel changes and resultant strokes and its successful treatment with balloon angioplasty.
ISSN:0090-3019
1879-3339
DOI:10.1016/j.surneu.2006.02.048