Central nervous system vasculitis

Case contributed by Hani Makky Al Salam
Diagnosis almost certain

Presentation

Decreased level of consciousness.

Patient Data

Age: 20 years
Gender: Male

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

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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