Case report
Cerebral rheumatoid vasculitis: a case report
1 Rheumatology Department, Hedi Chaker Hospital, Sfax, Tunisia
2 Neurology Department, Habib Bourguiba Hospital, Sfax, Tunisia
Journal of Medical Case Reports 2012, 6:302 doi:10.1186/1752-1947-6-302
Published: 13 September 2012Abstract
Introduction
Central nervous system involvement in rheumatoid arthritis is infrequent. The most frequent neurological manifestations of rheumatoid arthritis are peripheral neuropathy and cervical spinal cord compression due to subluxation of the cervical vertebrae. Cerebral rheumatoid vasculitis is an uncommon and serious complication which can be life-threatening.
Case presentation
A 52-year-old North African Tunisian Caucasian woman presented with a six-week history of headache. She had suffered seropositive and destructive rheumatoid arthritis for nine years without any extra-articular complications. Magnetic resonance imaging of the brain with the T2 sequence showed high-intensity signal images at the frontal and parietal cortico-subcortical junction suggesting hemispheric vasculitis.
Conclusions
Cerebral vasculitis is an infrequent complication in rheumatoid arthritis which is associated with high morbidity and in some cases can be life-threatening. Early assessment and a high index of suspicion to recognize such complications are essential in managing these patients.
