Abstract
Primary angiitis of the central nervous system (PACNS) is a rare vasculitis in the central nervous system. Herein, we report a case of diagnosis and treatment of necrotic pattern PACNS, which was difficult to differentiate from a brain abscess. A 19-year-old male presented with blurred vision and a headache. Brain MRI revealed irregular rim-enhancing necrotic masses with central diffusion-high signal intensity in the corpus callosum and peripheral diffusion-high signal intensity in the left parietotemporal periventricular area. Susceptibility-weighted imaging revealed multiple punctate hemorrhages in the lesions. The patient was diagnosed with unusual abscess or tumefactive PACNS. Therefore, we initially treated the patient with antibiotics to rule out brain abscess. However, the brain lesions did not improve on follow-up MRI after the antibiotic treatment. Surgical biopsy was performed, and the histopathological diagnosis was PACNS with a necrotic pattern. The necrotic lesions became smaller on follow-up MRI after high-dose corticosteroid treatment.
Original language | English |
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Pages (from-to) | 1367-1372 |
Number of pages | 6 |
Journal | Journal of the Korean Society of Radiology |
Volume | 84 |
Issue number | 6 |
DOIs | |
State | Published - Nov 2023 |
Bibliographical note
Publisher Copyright:Copyrights © 2023 The Korean Society of Radiology.
Keywords
- Brain Abscess
- Central Nervous System
- Vasculitis