Abstract

Dr. Omar Farooq, Dr. Mahpara Andrabi*, Dr. Azhar Hafiz and Dr. Shahnawaz

ABSTRACT

Primary central nervous system vasculitis (PCNSV) is a rare inflammatory arteriopathy confined to the brain, spinal cord, and leptomeninges. Because of its nonspecific presentation and difficulties in making a positive diagnosis, empiric treatment is often instituted. Diagnostic criteria include newly acquired neurological deficits, unexplained by another central nervous system (CNS) or systemic process, in the presence of a highly suggestive angiogram and/or biopsy. There are few cases each year making further characterization and correct diagnosis difficult. The patient discussed here is a 65 year old male who was admitted as a case of status epilepticus in our casualty. Patient was found seizing on the roadside by some passers by and was brought to our hospital in unconscious state. MRI brain revealed large infarcts in the distribution of right MCA and ACA territory. CSF was cellular with lymphocytic pleocytosis and elevation in proteins with normal sugars. A diagnosis was primary CNS vasculitis was made and patient received IV Methylprednisolone for 5 days and improved significantly.