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From the Departments of Neurology (Drs. Alrawi and Trobe), Ophthalmology and Visual Sciences (Drs. Trobe and Musch), and Pathology (Neuropathology) (Dr. Blaivas), University of Michigan Medical School, and Department of Epidemiology, University of Michigan School of Public Health (Dr. Musch), Ann Arbor, MI.
Address correspondence and reprint requests to Dr. Jonathan D. Trobe, 1000 Wall Street, Ann Arbor, MI 48195.
To determine the yield of brain biopsy and the predictive value of clinical features and ancillary studies, we retrospectively analyzed hospital chart data from 61 consecutive patients suspected of having primary angiitis of the CNS (PACNS). Biopsies disclosed PACNS in 22 (36%), alternative diagnoses in 24 (39%), and no diagnosis in 15 (25%). Clinical indicators and angiography were not useful predictors of PACNS. Brain biopsy should be the primary diagnostic tool in this setting because of the poor reliability of other indicators and because of the high yield of alternative diagnoses requiring different management.
Key words: Primary angiitis of the CNS—Brain biopsy—Diagnosis.
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