Cerebral vasculitis secondary to Wegener's granulomatosis: computed tomography and angiographic findings

A Patient with Wegener’s Granulomatosis Presenting with a Subarachnoid Hemorrhage: Case Report and Review of CIMS Disease Associated with Wegener’s Granulomatosis

“…Two patients developed their SAH 3 and 36 months following the diag nosis of WG, and cerebral angiograms were negative in both cases [6], The other two SAHs were diagnosed at autopsy [5,7]. The last 3 patients presented with cerebral vasculitis, seizures, and a cerebrovascular accident, re spectively [10][11][12], CNS involvement in WG is caused primarily by three mechanisms: (l) Contiguous extension of granulomatous inflammation from primary sites outside the CNS. Nasal granulomata may extend to orbit or middle fossa.…”

“…There have been 7 previously documented patients with WG that either presented with or developed CNS complications [5][6][7][10][11][12] Four of the 7 patients developed a SAH. Two patients developed their SAH 3 and 36 months following the diag nosis of WG, and cerebral angiograms were negative in both cases [6], The other two SAHs were diagnosed at autopsy [5,7].…”

Wegener’s Granulomatosis Presenting with Intracerebral Hemorrhages

“…In fact, histologically or radiologically confirmed vasculitis of the CNS in Wegener's granulomatosis is very rare; moreover, the small vessels typically affected in Wegener's granulomatosis (although large vessels in the brain can also be involved) are below the sensitivity of routine angiography. Nevertheless, cerebral vasculitis related to Wegener's granulomatosis has been reported to result in intraparenchymal or subarachnoid hemorrhage [10][11][12][13][14].…”

Hemorrhagic complications associated with PR3-ANCA crescentic glomerulonephritis

“…By themselves, cerebral imaging methods may not be able to the specific findings of vasculitis that include irregularity of arterial walls or obstruction of arteries. 21 The clinical course of patients with cerebral hemorrhage is rapid progressive and the prognosis is poor. Less symptomatic lesions may respond to immunosuppressive therapy, 22 while more extensive and life-threatening lesions require emergency surgery in view of the associated highmortality rate.…”