vasculitis Flashcards Preview

neuroinflammation > vasculitis > Flashcards

Flashcards in vasculitis Deck (18):
1

vasculitis can either be..

part of disease process

or

a disease entity

2

when is vasculitis part of a disease process?

pachymeningitis in wegener's granulomatosis

mononeuropathy multiplex in CTD

3

when can be vasculities be a disease entity?

granulomatosis angitis of CNS (20% OF CNS vasculitis)

isolated peripheral nerve vasculitis

4

what are the commonest presenting neurological features of vasculitis?

headaches

stroke like episodes/focal neurological deficits

encephalopathic (confusion, agitation, decreased level of consciousness)

foot drop/asymmetric neuropathy

5

what are three other non-neurological symptoms of vasculitis

systemically unwell
additional organ involvement
muscle involvement

6

what other additional neurological symptoms can present with vasculitis

mononeuropathy complex
cranial nerve palsies
cognitive deficits

7

what percentage of vasculitis is isolated to CNS?

26%

8

list 6 types of vasculitis

giant cell arteritis
wegener's spectrum
associated with CTD
isolated pachymeningitis
churg struass
isolated to PNS

9

what are the differential diagnosis for vasculitis

CNS infections : HSE, TB, viral encephalitis, HIV

CNS malignancy: malignant meningitis, lymphomas

venous sinus thrombosis

subarachnoid haemorrhage/vasospasm

embolic strokes due to SBE

reversible cerebral vasoconstriction

10

what secondary causes of vasculitis exist?

HIV
varicella zoster
TB
syphilis

Hep C in association with mailgnancies

in association with connective tissue diseases

11

what signs would a blood test show for vasculitis

raised inflammatory markers at baseline

ESR 80% (mean 70)
CRP 70% (mean 93)
Low Albumin 73%
normochromic anaemia 57%

high platelet count 46%

although up to 20% show no abnormalities

12

what would be the result of an immunology test for vasculitis?

one or more abnormalities in <50%

RF
P OR C ANCA with positive MPX, MP3

ANF, Ro and/or LA (ENA)

Cryoglobulins
lots of patients havw MGUS

13

in what percentage of vasculitis patients is the CSF examination abnormal? and what abnormalities are present?

up to 60-80%

raised protein (50%)
lymphocytes (25%)
OCB's (20%)
matched bands (25%)
blood (15%)

14

if the MRI is normal is it likely or unlikely that the patient has CNS vasculitis?

highly unlikely

15

what imaging techniques can be useful in diagnosing CNS vasculitis?

MRI

(imaging the arteries) MRA
CTA or 4 Vessel angiogram
( abnormal angiogram does not diagnose)

DWI- vasculitic strokes

16

what precipitating factors are associated with Reversible cerebral vasoconstriction syndrome but not vasculitis?

drugs: canabis, cocaine, emphatamines, ephedrine, erotamine, SSRI, IVigs

Pregnancy and pueperium

idiopathic

17

what features distinguish Reversible Cerebral vasoconstriction syndrome from CNS vasculitis?

female predominance

acute onset headache (Mimicks SAH)

usually no prodromal illness

no focal neurology

abnormal angiogram or CTA or MRA

usually normal MRI but may have cortical SAH, intracerebral bleed or CVA

18

what is the difference between vasculitis and vasculopathy?

Vasculitis denotes a heterogeneous group of clinical entities which all are characterized by the inflammatory process of arterial and venous walls of any size and in any organ, quite frequently in the skin.


Vasculopathy, on the other hand, refers to vascular and capillary lesions caused by, for example, some medications.