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Benign focal cerebral vasculitis

Case report

From the Departments of Neurology (Drs. Berger and Romano), Internal Medicine (Dr. Berger), and Pathology (Dr. Norenberg), the University of Miami School of Medicine; and the Department of Neurology (Dr. Menkin), Baptist Hospital, Miami, FL.
Received August 30, 1994. Accepted in final form February 7, 1995.
Address correspondence and reprint requests to Dr. Joseph R. Berger, Department of Neurology, University of Kentucky College of Medicine, Chambers Building (Annex 4), Room 228, 800 Rose Street, Lexington, KY 40536.

We report a 47-year-old man who presented with partial seizures complicating focal cerebral vasculitis of the right temporal lobe. Excisional biopsy of the mass lesion revealed fibrinoid necrosis of small vessels. These vessels were infiltrated by neutrophils, eosinophils, lymphocytes, and plasma cells. Despite extensive evaluation, no etiology was apparent for the vasculitis. No immunosuppressive agents were administered, and 4 1/2 years after the diagnosis, he remains healthy except for an incongruous left homonymous hemianopia. Follow-up cranial magnetic resonance images revealed only postoperative changes. This case demonstrates that focal lesions and a benign course may represent one end of the spectrum of primary angiitis of the central nervous system.

NEUROLOGY 1995;45: 1731-1734

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