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Fortschr Neurol Psychiatr 2019; 87(02): 129-132
DOI: 10.1055/a-0743-5558
Kasuistik
© Georg Thieme Verlag KG Stuttgart · New York

Rare Presentation of a Relapsing Remitting Central Nervous System Vasculitis: A Case Report.

Seltene Präsentation eines schubförmig remittierender Zentralnervensystem Vaskulitis - Fallbericht.
Maksymilian Brzezicki
1   Bristol Institute of Clinical Neurosciences, Southmead Hospital; University of Oxford Nuffield Department of Clinical Neurosciences
,
Matthew Kobetic
2   University of Bristol, Faculty of Health Sciences
,
Dillon Serena
3   University of Oxford Nuffield Department of Clinical Neurosciences
› Author Affiliations
Further Information

Publication History

eingereicht 23 April 2018

akzeptiert 10 September 2018

Publication Date:
25 February 2019 (online)

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Zusammenfassung

Wir berichten über einen interessanten Fall einer Vaskulitis des zentralen Nervensystems, der eine schubförmig-remittierende Natur und ein bisher nicht berichtetes Profil kognitiver Defizite bei dieser Variante der Erkrankung aufweist.

Der Patient stellte sich mit beidseitigem Kopfschmerz, Gesichtsfeldverlust des linken Auges, Dyschromatopsie und vorübergehender Bewusstlosigkeit vor. Er wurde in den letzten acht Jahren auf ähnliche Symptome untersucht. Es gab eine klare schubförmig-remittierende Geschichte, mit Perioden voller Remission von 4-6 Monaten.

MRT-Untersuchungen zeigten bilaterale Bereiche von Hyperintensitäten, repräsentativ für kleine „nicht-charakteristische“ Veränderungen, wahrscheinlich vaskulären Ursprungs.

In diesem Bericht wird die klinische Konundra während der Evaluation des Patienten diskutiert, mögliche Differentialdiagnosen untersucht und über die hypothetische Rolle der Statinverwendung in ähnlichen Fällen kommentiert.

Abstract

We report an interesting case of a central nervous system vasculitis, presenting with a relapsing remitting nature and a previously unreported profile of cognitive deficits in this variant of the disease.

The patient presented with bilateral headache, left eye upper temporal quarter visual field loss, dyschromatopsia and a transient loss of consciousness. He was previously evaluated for similar set of symptoms over the past eight years. There was a clear relapsing-remitting history, with periods of full remission of 4-6 months.

MR studies showed bilateral areas of hyperintensities, representative of small “non-characteristic” changes, likely of a vascular origin.

The case discusses clinical conundra during the patient’s evaluation, examines possible differential diagnoses and comments on the hypothesised role of statin use in similar cases.

Schlüsselwörter

Differenzialdiagnose - kognitive Neurologie - vaskuläre Neurologie - Akut-Neurologie - Vaskulitis

Key words

differential diagnosis - cognitive neurology - vascular neurology - acute neurology - vasculitis
 

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