Successful emergent angioplasty of neurosarcoid vasculitis presenting with strokes

Surg Neurol. 2006 Oct;66(4):402-4. doi: 10.1016/j.surneu.2006.02.048.

Abstract

Background: Sarcoidosis is a systemic disease with neurologic involvement in approximately 5% of cases. Ischemic events related to neurosarcoid vasculitis are rare. We report the successful treatment of symptomatic neurosarcoid vasculitis with angioplasty.

Case description: A 41-year-old African American with a diagnosis of neurosarcoid presented with aphasia and right-sided weakness. He was treated medically with antiplatelet agents, heparinization, and hypertensive therapy. Despite this treatment, he experienced clinical worsening and radiographic extension of his infarcts. He underwent successful angioplasty of a severe focal stenosis of the left middle cerebral artery. After the procedure, he experienced marked improvement in his symptoms and at follow-up continues to improve.

Conclusions: We report the angiographic demonstration of neurosarcoidosis with large vessel changes and resultant strokes and its successful treatment with balloon angioplasty.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Angioplasty, Balloon / instrumentation
  • Angioplasty, Balloon / methods*
  • Angioplasty, Balloon / trends
  • Anterior Cerebral Artery / diagnostic imaging
  • Anterior Cerebral Artery / pathology
  • Anterior Cerebral Artery / surgery
  • Anticoagulants / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Aphasia / etiology
  • Aphasia / physiopathology
  • Aphasia / surgery
  • Basilar Artery / diagnostic imaging
  • Basilar Artery / pathology
  • Basilar Artery / surgery
  • Brain / blood supply
  • Brain / pathology
  • Brain / physiopathology
  • Cerebral Angiography
  • Disease Progression
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Cerebral Artery / diagnostic imaging
  • Middle Cerebral Artery / pathology
  • Middle Cerebral Artery / surgery
  • Paresis / etiology
  • Paresis / physiopathology
  • Paresis / surgery
  • Sarcoidosis / complications*
  • Sarcoidosis / physiopathology
  • Stroke / etiology*
  • Stroke / physiopathology
  • Stroke / surgery*
  • Treatment Outcome
  • Vasculitis, Central Nervous System / etiology*
  • Vasculitis, Central Nervous System / physiopathology
  • Vasculitis, Central Nervous System / surgery*

Substances

  • Anticoagulants
  • Antihypertensive Agents