Microscopic polyangiitis presenting with medullary infarct

J Neurol Sci. 2011 Jan 15;300(1-2):173-5. doi: 10.1016/j.jns.2010.09.016.


Microscopic polyangiitis is a small vessel vasculitis which is rarely associated with ischemic stroke. Cerebrovascular disease has rarely been reported in connection with this disease. It may cause fatal hemorrhage, hemorrhagic conversion and multiple lacunar infarcts. We report here a 55-year-old woman with left medullary oblangata infarction without any symptoms of microscopic polyangiitis. During hospitalization, retinal ischemia, mononeuritis multiplex and pulmonary infiltration developed. Sural nerve biopsy was concomitant with small vessel vasculitis. Elevated CRP and sedimentation and positive P-ANCA led to confirmation of a diagnosis of microscopic polyangiitis. Our patient is a rare case of microscopic polyangiitis presenting with medullary infarction. Although the characteristics of this disease are well-known, the first symptom can be a medullary infarction, which has not been reported in literature before.

Publication types

  • Case Reports

MeSH terms

  • Brain Stem Infarctions / complications*
  • Brain Stem Infarctions / pathology
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Medulla Oblongata / blood supply*
  • Medulla Oblongata / pathology
  • Microscopic Polyangiitis / complications*
  • Microscopic Polyangiitis / pathology
  • Middle Aged