Central nervous system vasculitis

Case contributed by Hani M. Al Salam
Diagnosis almost certain

Presentation

Decreased level of consciousness.

Patient Data

Age: 20 years
Gender: Male
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Info

Multiple patchy regions of low attenuation particularly in the parietal regions. 

This study is a stack
Axial
FLAIR
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Axial
T2
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Axial
T1
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Axial
T1 C+
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Sagittal
T1
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Sagittal
T1 C+
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Coronal
T1 C+
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Coronal T2
fat sat
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Axial
ADC
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Axial
Gradient Echo
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Axial
PD
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MRA
This study is a stack
MRA
This study is a stack
MRA
This study is a stack
MRA
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Info

Multiple patchy regions of T2 signal abnormality involving predominantly subcortical white matter are demonstrated, without hemorrhage or abnormal enhancement. 

MRA shows diffuse attenuation of intracranial arteries with multiple microaneurysms.

Case Discussion

This 20-year-old male has established systemic polyarteritis nodosa with secondary involvement of his brain. 

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