Investigation
The systemic auto-antibodies and inflammatory markers are normal.
The chest radiograph is normal which should help distinguish cases of neurosarcoid and Churg-Strauss vasculitis.
MRI scanning of the brain reveals:
- multiple white matter lesions
- multiple cortical lesions
- occasionally there may be large areas of high signal
The cerebrospinal fluid may show:
- elevated protein
- lymphocyte pleocytosis
Cerebral angiography may show:
- irregular narrowing of intracranial arteries
- blunt-ending of intracranial arteries
Brain biopsy shows:
- inflammation of small arteries (100-500 microns)
- lymphocyte infiltration
- small numbers of giant cells
- thrombosis of vessels corresponds to infarcted areas
- there is variable meningeal involvement
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