Cerebral vasculitis, a diagnostic labyrinth

A diagnosis of cerebral vasculitis is frequently considered in patients with new or progressive neurological symptoms for which there is no other explanation. A clinician considering a diagnosis of cerebral vasculitis should be well aware of alternative diagnoses, since these are generally more common. Several consecutive examinations are required for diagnosing cerebral vasculitis, because there is no diagnostic procedure that is highly sensitive as well as highly specific. The added value of the different procedures may depend on the type of blood vessels involved. Standard MRI examinations are sensitive but not specific. Special MRI techniques now make it also possible to make images of the vessel wall itself. Catheter angiography remains important, especially when noninvasive angiographic techniques do not reveal any abnormalities. Brain biopsy can provide proof of cerebral vasculitis and also serves to exclude mimicking conditions.</p

Cerebrale vasculitis, een diagnostisch doolhof

A diagnosis of cerebral vasculitis is frequently considered in patients with new or progressive neurological symptoms for which there is no other explanation. A clinician considering a diagnosis of cerebral vasculitis should be well aware of alternative diagnoses, since these are generally more common. Several consecutive examinations are required for diagnosing cerebral vasculitis, because there is no diagnostic procedure that is highly sensitive as well as highly specific. The added value of the different procedures may depend on the type of blood vessels involved. Standard MRI examinations are sensitive but not specific. Special MRI techniques now make it also possible to make images of the vessel wall itself. Catheter angiography remains important, especially when noninvasive angiographic techniques do not reveal any abnormalities. Brain biopsy can provide proof of cerebral vasculitis and also serves to exclude mimicking conditions