Central Nervous System (CNS) Vasculitis

Central Nervous System (CNS) Vasculitis

Overview

Vasculitis is a blanket term for conditions that cause inflammation in the blood vessels, specifically in the brain and central nervous system. Vasculitis is a dangerous disease that can result in loss of oxygen supply to critical brain or spinal cord tissue. Primary central nervous system vasculitis is confined to the brain and the spinal cord. Secondary central nervous system vasculitis is accompanied by an autoimmune condition or a viral or bacterial infection. Diagnosis of CNS vasculitis is challenging because the symptoms are similar to many other disorders

Signs and symptoms

Symptoms of CNS vasculitis include headaches, memory disturbances, speech slurring, and weakness of limbs. Systemic vasculitis will also have skin rashes, fatigue, unexplained weight loss, fever, joint pains, abdominal pain, dark urine and numbness.

Causes

The exact mechanism of inflammation in the vessels of the brain is unclear. In some cases, the vasculitis appears to be caused by either an immune response or a viral infection. However, in many cases, the cause remains unexplained.

Risk factors

In general, central nervous system vasculitis is quite rare. It can occur in patients of any age or gender, but appears to be most common in men above 50 years of age.

Complications

Patients with central nervous system vasculitis may develop complications such as osteoporosis, pneumonia and other infections. Patients are also at risk of relapse.

Diagnosis

Diagnosing central nervous system vasculitis is a challenge because it has symptoms that are very similar to many other neurological diseases. The doctor will begin with a physical and neurological exam and a patient medical history. The doctor will also need a panel of blood tests to check for anaemia, elevated white blood count, elevated platelet count and inflammation markers. The patient will also need a CT scan, an MRI scan and a cerebral angiogram. The doctor may also require Menigeal and brain tissuee biopsies and a lumbar puncture.

Treatment

CNS Vasculitis is treated in stages. The initial stage is induction therapy. In this phase, high-dose steroids are usually administered, often intra-venously. This is done with or without immunosuppressant therapy to decrease the body’s autoimmune response. These steroids are reduced and stopped over a course of six months. This usually put the disease in remission. This is the maintenance stage. In this stage the patient is treated with low doses of steroids and immunosuppressants to keep the symptoms under control. The treatment for CNS Vasculitis is usually prolonged, and may, in some cases, be for life.

Prevention

As the cause is unknown, Central Nervous System Vasculitis cannot be prevented.

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