Vasculitis of the brain

 

What is vasculitis of the brain?

 

The brain and the spine make up the central nervous system.) CNS vasculitis often occurs in the following situations: accompanied by other autoimmune diseases such as systemic lupus erythematosus, dermatomyositis, and, rarely, rheumatoid arthritis. As well as infection, such as viral or bacterial.

 

The actual cause of these vasculitis diseases is usually not known. However, immune system abnormality and inflammation of blood vessels are common features. Each form of vasculitis has its own characteristic pattern of symptoms, much of which depends on what particular organs are affected.

 

Inflammatory brain disease, also referred to as inflammatory disease of the central nervous system (CNS), is a condition where the brain and/or spinal cord become inflamed. Inflammation in the brain causes irritation and swelling of brain tissue or blood vessels. Brain inflammation can occur for a variety of reasons.

 

Vasculitis is a condition that involves inflammation in the blood vessels. The condition occurs if your immune system attacks your blood vessels by mistake. This may happen as the result of an infection, a medicine, or another disease or condition.

Cerebral vasculitis or central nervous system vasculitis (sometimes the word angiitis is used instead of “vasculitis”) is vasculitis (inflammation of the blood vessel wall) involving the brain and occasionally the spinal cord. It affects all of the vessels: very small blood vessels (capillaries), medium-size blood vessels (arterioles and venules), or large blood vessels (arteries and veins). If blood flow in a vessel with vasculitis is reduced or stopped, the parts of the body that receive blood from that vessel begins to die. It may produce a wide range of neurological symptoms, such as headache, skin rashes, feeling very tired, joint pains, difficulty moving or coordinating part of the body, changes in sensation, and alterations in perception, thought or behavior, as well as the phenomena of a mass lesion in the brain leading to coma and herniation. Some of its signs and symptoms may resemble multiple sclerosis. 10% have associated bleeding in the brain.

“Inflammation” refers to the body’s response to injury, including injury to the blood vessels. Inflammation may involve pain, redness, warmth, swelling, and loss of function in the affected tissues.

In vasculitis, inflammation can lead to serious problems. Complications depend on which blood vessels, organs, or other body systems are affected.

Vasculitis can be caused by underlying pathologies:

Classifications + Pathophysiology

 

SLE (single organ vasculitis) RA

Immunosuppressed – ie; RA

Viral – ie; chicken pox

TB

Fungal

Drug related central nervous system (CNS) abnormality

 

It is best seen on digital subtraction imaging and can also be seen on an angio.

 

You get Arachnoid granulation in venous imaging

Cerebral venous sinus thrombosis

Usually 62 Hounsfield units

Delta sign (Empty delta sign)

 

https://images.radiopaedia.org/images/6778/1e73b0faaaee30a45c069951abaa4a_big_gallery.jpg

This is a filling defect on a venogram

Cord sign

dural venous sinus thrombosis.

https://radiopaedia.org/articles/cord-sign-dural-sinus-thrombosis

Cerebral Vasculitis

The disruption in blood flow caused by inflammation can damage the body’s organs. Signs and symptoms depend on which organs have been damaged and the extent of the damage.

Typical symptoms of inflammation, such as fever and general aches and pains, are common among people who have vasculitis.

Outlook

There are many types of vasculitis, but overall the condition is rare. If you have vasculitis, the outlook depends on:

• The type of vasculitis you have
• Which organs are affected
• How quickly the condition worsens
• The severity of the condition
• Treatment often works well if it’s started early. In some cases, vasculitis may go into remission. “Remission” means the condition isn’t active, but it can come back, or “flare,” at any time.

Sometimes vasculitis is chronic (ongoing) and never goes into remission. Long-term treatment with medicines often can control the signs and symptoms of chronic vasculitis.  Rarely, vasculitis doesn’t respond well to treatment. This can lead to disability and even death.

Much is still unknown about vasculitis. However, researchers continue to learn more about the condition and its various types, causes, and treatments.

 

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