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- W3157228232 abstract "Objective: To report an atypical presentation of primary central nervous system (CNS) angiitis affecting the spinal cord. Background: Primary CNS angiitis is a challenging clinical entity without reliable methods of definitive diagnosis that frequently mimics more common disease processes such as cerebral ischemia and neuroinflammatory disorders. We report a case of biopsy proven primary CNS angiitis that presented as longitudinally extensive transverse myelitis. A prior case series reported spinal cord involvement in Design/Methods: This is a clinical case report with radiographic and pathological correlation. Results: A 25 year old man developed low back pain and burning parasthesias in his lower extremities in August 2016. Over the next several months, he went on to develop urinary retention and worsening weakness in his bilateral lower extremities eventually requiring assistive devices to ambulate. Physical exam demonstrated normal cranial nerve function, with flaccid paraparesis, impaired vibration/proprioception, and absent reflexes in the lower extremities. MRI demonstrated extensive T2 hyperintensities from T10 to the conus with patchy enhancement that extended to the exiting lumbosacral nerve roots. Lumbar puncture revealed protein of 337 mg/dL, 305 white blood cells (91% lymphocytes without monoclonal populations), negative infectious markers and no oligoclonal bands. Patient received intravenous methylprednisolone and plasma exchange with mild improvement in his symptoms. Repeat MRI in January demonstrated new cerebral involvement that worsened on serial examination. A cerebral angiogram was negative prompting a surgical biopsy that demonstrated granulomatous inflammation in the blood vessel walls without signs of an infectious process or parenchymal inflammation. Conclusions: This case report demonstrates a diagnostic pitfall that deserves to be recognized and included in the differential diagnosis for this clinical syndrome. Delays in diagnosis in cases of primary CNS angiitis can lead to significant morbidity for patients. Disclosure: Dr. Benesh has nothing to disclose. Dr. Pennington has nothing to disclose. Dr. Fallon has nothing to disclose. Dr. Rinker has nothing to disclose." @default.
- W3157228232 created "2021-05-10" @default.
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- W3157228232 date "2018-04-10" @default.
- W3157228232 modified "2023-09-27" @default.
- W3157228232 title "A Case of Primary CNS Angiitis Presenting as Longitudinally Extensive Transverse Myelitis (P6.228)" @default.
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