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Open Access 01-02-2025 | Cerebral Vasculitis | Original Communication

Cerebral vasculitis related to neurosarcoidosis: a case series and systematic literature review

Authors: Jan K. Focke, Mosche Brokbals, Jana Becker, Roland Veltkamp, Diederik van de Beek, Matthijs C. Brouwer, Willeke F. Westendorp, Markus Kraemer

Published in: Journal of Neurology | Issue 2/2025

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Abstract

Cerebral vasculitis is a rare but severe manifestation of neurosarcoidosis (NS) that has received little attention. The aim of the present study was to characterize clinical and diagnostic features as well as potential treatment strategies of cerebral vasculitis related to NS. We assessed 29 patients with cerebral vasculitis related to NS (15 female, mean age at time of diagnosis 45 years, SD = 11.85) among these were four new cases from our hospital records and 25 previously published cases from a systematic literature review. The demographic, clinical, and diagnostic features of those 29 patients with cerebral vasculitis related to NS were compared with a group of 73 NS patients without vasculitic involvement (37 female, mean age at time of diagnosis 47 years, SD = 14.79). Neurologic deficits and MRI abnormalities were significantly more frequent in cerebral vasculitis related to NS than in NS without vasculitic involvement. Patients with cerebral vasculitis related to NS significantly more often presented with headache, motor symptoms, and cognitive and/or behavioral changes. Non-neurologic manifestations of sarcoidosis did not significantly differ in character or frequency between both groups. Glucocorticoids in combination with methotrexate, cyclophosphamide, or infliximab were the most frequently used treatment strategies in cerebral vasculitis related to NS. Within the complex diagnostic work-up that is required in cerebral vasculitis related to NS sufficient angiographic imaging as digital subtraction angiography or MRI vessel wall imaging and tissue biopsy are of particular significance as they can detect vascular changes caused by inflammatory processes.
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Literature
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go back to reference Degardin A, Devos P, Vermersch P, de Seze J (2010) Cerebrovascular symptomatic involvement in sarcoidosis. Acta Neurol Belg 110:349–352PubMed Degardin A, Devos P, Vermersch P, de Seze J (2010) Cerebrovascular symptomatic involvement in sarcoidosis. Acta Neurol Belg 110:349–352PubMed
Metadata
Title
Cerebral vasculitis related to neurosarcoidosis: a case series and systematic literature review
Authors
Jan K. Focke
Mosche Brokbals
Jana Becker
Roland Veltkamp
Diederik van de Beek
Matthijs C. Brouwer
Willeke F. Westendorp
Markus Kraemer
Publication date
01-02-2025
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 2/2025
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-024-12868-2

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