Primary angiitis of the CNS (PACNS) with predominant cranial neuropathy and spinal cord involvement.

Abstract

We describe a 70-year old man with a history of repeated epidural injections for chronic low back pain, presenting with headache, cranial nerve palsies and progressive myelopathy. Meningeal enhancement was initially seen in the posterior epidural space of the T(10)-T(12) spine on MRI. Extensive laboratory investigation showed normal or negative results except for persistent pleocytosis, elevated protein and absence of demonstrable microorganisms on CSF studies. Despite conventional and empirical treatments, the patient developed progressive neurological deterioration leading to death. Autopsy showed Primary angiitis of the CNS (PACNS) with predominant cranial neuropathy, spinal cord involvement and extensive myelomalacia.

• Authors: Orestes E Solis, Rupal I Mehta, Suman Kalanithi, Yvette Bordelon, Noriko Salamon, William H Yong, Harry V Vinters
• Journal: Neuropathology : official journal of the Japanese Society of Neuropathology (Neuropathology) Vol. 30 Issue 3 Pg. 267-72 (Jun 2010) ISSN: 1440-1789 [Electronic] Australia
• PMID: 19751245 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Cranial Nerve Diseases (complications, diagnosis, therapy)
• Fatal Outcome
• Humans
• Male
• Spinal Cord Diseases (complications, diagnosis, therapy)
• Thoracic Vertebrae (pathology)
• Vasculitis, Central Nervous System (complications, diagnosis, therapy)