G - 22 Lésions vasculaires cérébrales et sarcoïdose

Degardin, A.; Sèze, Jérôme De; Delalande, S.; Devos, P; Vermersch, Patrick

doi:10.1016/s0035-3787(07)90528-7

Cited by 2 publications

(10 citation statements)

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“…Nervous system involvement of the facial nerve (VII) and the optic nerve and its chiasm is revealed by a swollen appearance with iso-signal T1, hyper-signal T2, and FLAIR, and enhanced after gadolinium injection [2,3]. In cases of parenchymal involvement, lesions of the white matter are found, similar to those in multiple sclerosis with U-fiber involvement and hyper-signal FLAIR and T2 not enhanced after gadolinium injection [3][4][5]. In the case of meningeal involvement, there is diffuse or focal micronodular thickening, predominantly at the base of the skull, supra-sellar, and fronto-basal regions, hyper-signal T2 and enhanced after gadolinium injection, forming in some cases true extra-axial pseudomasses by coalescence of sarcoid granulomas [2][3][4]7].…”

Section: Discussionmentioning

confidence: 99%

“…Due to its unusual occurrence, sarcoidosis rarely causes vasculitis in the cerebral nervous system [3]. All parts of the nervous system and its coverings can be affected in neurosarcoidosis, including the cerebral parenchyma, nerve roots, meninges, dura mater, and adjacent bone structures [3,4]. Less commonly, sarcoid granulomas can cause perivascular inflammation and infiltrate the walls of intracranial blood vessels, leading to cerebrovascular events such as infarction, venous thrombosis, hemorrhages, and intracranial vasculitis [4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…All parts of the nervous system and its coverings can be affected in neurosarcoidosis, including the cerebral parenchyma, nerve roots, meninges, dura mater, and adjacent bone structures [3,4]. Less commonly, sarcoid granulomas can cause perivascular inflammation and infiltrate the walls of intracranial blood vessels, leading to cerebrovascular events such as infarction, venous thrombosis, hemorrhages, and intracranial vasculitis [4][5][6]. In addition, it should be noted that certain radiological features of neurological involvement are strongly suggestive of the diagnosis, notably micronodular thickening of the meninges and hypothalamic-pituitary involvement.…”

Section: Discussionmentioning

confidence: 99%

“…As reported in the literature, a cerebral MRI was performed in our patient following a normal cerebral CT scan. In MRI, neurosarcoidosis more often affects the base of the skull and the cranial nerves [1][2][3][4]. Nervous system involvement of the facial nerve (VII) and the optic nerve and its chiasm is revealed by a swollen appearance with iso-signal T1, hyper-signal T2, and FLAIR, and enhanced after gadolinium injection [2,3].…”

Section: Discussionmentioning

confidence: 99%

“…In the case of meningeal involvement, there is diffuse or focal micronodular thickening, predominantly at the base of the skull, supra-sellar, and fronto-basal regions, hyper-signal T2 and enhanced after gadolinium injection, forming in some cases true extra-axial pseudomasses by coalescence of sarcoid granulomas [2][3][4]7]. They can extend by extension toward the hypothalamohypophyseal axis, appearing as iso signal T1, iso, or hyposignal T2 enhanced after gadolinium injection [3,4]. More rarely, and as reported in our case, vasculitis due to cerebral sarcoidosis can occur, illustrated on MRI either by thickening and contrast uptake of vascular walls after gadolinium injection or in some cases by intracranial hemorrhages manifesting as hyposignals (microbleeds) on magnetic susceptibility sequences (gradient echo T2 or susceptibility weighted imaging) and venous or arterial thromboses of the stroke type [5,6].…”

Section: Discussionmentioning

confidence: 99%

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Cerebral Vasculitis Revealing Systemic Sarcoidosis: A Case Report and Review of the Literature

Gakosso¹,

Badr²,

Zouine³

et al. 2023

Cureus

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Vasculitis in neurosarcoidosis is rare, with only a few cases reported in the literature. We report the clinical observation of a 51-year-old patient with no previous medical history, who was admitted to the emergency department due to sudden onset confusion, fever, sweating, weakness, and headaches. The first brain scan was normal, but a further biological exam with a lumbar puncture revealed lymphocytic meningitis. A complementary cerebral MRI revealed abnormalities in the white matter signal, suggestive of multiple sclerosis, with petechial hemorrhagic foci associated with leptomeningeal involvement and cerebral vasculitis. Thoraco-abdomino-pelvic computed tomography revealed hilar and mediastinal lymphadenopathy, as well as lymph nodes in the lower cervical region. A biopsy of the lymph nodes confirmed the presence of non-caseating granulomatous inflammation consistent with sarcoidosis. Highdose corticosteroid therapy was initiated with good clinical outcomes. Cerebral vasculitis in neurosarcoidosis is rare but can lead to neurological complications requiring long-term multidisciplinary management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Cerebral Vasculitis Revealing Systemic Sarcoidosis: A Case Report and Review of the Literature

Gakosso¹,

Badr²,

Zouine³

et al. 2023

Cureus

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Vasculitis in Patients With Sarcoidosis

et al. 2022

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Objectives: Vasculitis in patients with sarcoidosis is rare and can affect any sized blood vessel. Limited information describing this association is available.Methods: A single-institution medical records review study was performed reviewing all patients with a diagnosis code for sarcoidosis and vasculitis between January 1, 1998, and December 31, 2019. Data were abstracted regarding diagnosis, treatment, and outcomes from medical records. Patients were diagnosed with vasculitis based on biopsy and/or arterial imaging. Comparison between patients presenting with large and/or medium vessel vasculitis (L/MVV) versus patients with only small vessel vasculitis (SVV) was performed.Results: Seventeen patients were identified during the study period. Nine patients (56% female) had L/MVV, and 8 (50% female) had SVV. Sarcoidosis preceded vasculitis in 4 (44%) L/MVVand 3 (38%) SVV. The mean ± SD age at sarcoidosis diagnosis was 53.2 ± 17.8 and 51.9 ± 11.4 years, and the mean ± SD age at vasculitis diagnosis was 57.4 ± 19.6 and 59.0 ± 13.4 years in L/MVV and SVV, respectively. Number of organ systems involved by sarcoidosis was similar (median [interquartile range], 3 [1-4] L/MVV vs 2.5 [1.75-3.25] SVV). The mean length of follow-up was 11.5 ± 12.8 in L/MVV and 13.1 ± 14.3 years in SVV. Complete response to therapy for vasculitis was observed in 8 of 9 with L/MVV and 7 of 8 with SVV. Four patients with SVV were able to stop all immunosuppression as compared with only 1 patient with L/MVV at the last follow-up. Conclusions:This series observed a comparable number of patients with L/MVV and SVV. Although a variety of treatments were used, most patients achieved remission regardless of vessel size affected. Clinicians should be aware of the overlap between sarcoidosis and vasculitis.

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G - 22 Lésions vasculaires cérébrales et sarcoïdose

Cited by 2 publications

References 0 publications

Cerebral Vasculitis Revealing Systemic Sarcoidosis: A Case Report and Review of the Literature

Cerebral Vasculitis Revealing Systemic Sarcoidosis: A Case Report and Review of the Literature

Vasculitis in Patients With Sarcoidosis

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