Acute central nervous system vasculitis as a manifestation of neurosarcoidosis: A case report and literature review

Abstract

Neurosarcoidosis (NS) affects various sites of the central nervous system, including the cranial nerve, meninges, brain parenchyma, hypothalamus, and pituitary gland. NS rarely causes intracerebral vasculitis and subsequent strokes, or cerebral infarction and hemorrhage, which are associated with high mortality. Herein, we report a 71-year-old woman's case of stroke associated with NS, which showed aggressive cerebral vasculitis with brain herniation; it was resolved with corticosteroid therapy after accurate histopathological diagnosis. This case highlights the necessity of expecting NS to sometimes follow an aggressive course, presenting with vasculitis. Most patients with NS satisfactorily respond to corticosteroids, but this is not always the case. In cases of unfamiliar ischemic or hemorrhagic lesions, the possibility of NS must be considered.

Neurosarcoidosis: Diagnostic Challenges and Mimics A Review

“…Neurosarcoidosis and CNS vasculitis have considerable overlap, with shared neuroimaging features, common laboratory and cerebrospinal fluid results, and even the presence of granulomas on biopsy [ 38 ••]. Systemic sarcoidosis is known to cause variable vessel vasculitis rarely, and case reports have shared that neurosarcoidosis may present with CNS vasculitis [ 39 , 40 •].…”