Castelnovo G, Bouly S, Vladut M, Marty-Double C, Labauge P
Service de Neurologie, CHU de Montpellier-Nimes, 2, avenue du Pr. Debre, 30029 Nimes Cedex, France.
Ann Med Interne (Paris). 2001 Jun;152(4):273-5.
Angiitis of the central nervous system involves a wide spectrum of clinical symptoms. Complementary exams (CSF, neuroradiological exams) are not very specific and sensitive. Diagnostic procedures often require cortical and leptomeningeal biopsy. Treatment, based on corticosteroids and cyclophosphamid, have greatly improved prognosis. We report a rapidly progress dementia syndrome that revealed angiitis of the central nervous system. Corticosteroid treatment did not prevent a fatal outcome. Autopsy findings confirmed the diagnosis of central nervous leucocytoclastic angiitis.
中枢神经系统血管炎涉及广泛的临床症状。辅助检查(脑脊液检查、神经放射学检查)特异性和敏感性都不是很高。诊断程序通常需要进行皮质和软脑膜活检。基于皮质类固醇和环磷酰胺的治疗已大大改善了预后。我们报告了一例以快速进展性痴呆综合征为表现的中枢神经系统血管炎。皮质类固醇治疗未能避免致命结局。尸检结果证实了中枢神经系统白细胞破碎性血管炎的诊断。