Presentation
Seizure
Patient Data
Moderate-sized, ill-defined T2W/FLAIR hyperintense area in the right frontal lobe. A few small patchy areas of T2W/FLAIR hyperintense areas are also seen in the bilateral frontal lobes and right temporal lobe. Multiple microhemorrhages are seen in the bilateral frontal and right temporal lobes, with multiple tiny nodular enhancing foci in these areas. Mild focal leptomeningeal enhancement overlies the right frontal lobe.
Case Discussion
A lumbar puncture was performed. CSF shows increased protein levels with normal glucose and chloride levels. The CSF differential count was also within normal limits.
The rapid meningitis PCR panel, gram stain, and AFB stain of CSF were normal.
An overall probable diagnosis of inflammatory cerebral amyloid angiopathy was made. The patient improved with steroid therapy.
The differential diagnosis includes primary CNS vasculitis.
Co-authors:
Dr. Deepa N.A. (DM, Neuro-medicine).
Dr. Sanaullah Mudassir (DM, Neuro-medicine).
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