Cerebral vasculitis and its facts

Life of Mayor Anisul Haque was claimed by cerebral vasculitis. It is an inflammation of the intracranial blood vessels. Small, medium and large vessels may be affected. Because of inflammation of the vessels blood to the affected site decreases, so some permanent damage to brain occurs. Men are affected twice as often as women.

Symptoms may include headache, neck ache, vomiting, stroke, abnormal protrusion of the eyeball(s), blurred vision, speech problem, problems of motor activities, weight loss, apnoea, black discolouration of skin primarily on the extremities, fluctuation of vital signs that is blood pressure, respiration, heart rate, convulsion and cranial nerves palsy.

Most often causes are not known. But auto immunity, infection, systemic lupus erythematosus, rheumatoid arthritis and some drugs may initiate cerebral vasculitis. It usually occurs after 50 years of age. Incidence is 18/100000 population in Europe. In our country we do not have any statistics.

Besides clinical signs and symptoms, laboratory tests are needed to confirm the diagnosis, such as complete blood count (CBC), C-reactive protein (CRP), magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), computerised tomographic angiography (CTA), positron emission tomography (PET) etc.

Management depends upon the presentation and severity of the disease. Treatment is first with many different high-dose steroids, namely glucocorticoids. Then, if symptoms do not improve additional immunosuppression are added to decrease the immune system's attack on the body's own tissues.

Cerebral vasculitis is a very rare condition that is difficult to diagnose, and as a result there are significant variations in the way it is diagnosed and treated. Intensive care unit (ICU) care is often needed. Regular neurological follow up is mandatory. Prognosis is usually not good and often unpredictable.

Early proper management may help the victim to prolong life. Wishing everyone a happy, healthy and disease free life.

The author is a Professor of Paediatrics at Community Based Medical College, Mymensingh.

E-mail: mmukkhan@gmail.com