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Intracranial stenosis treated with stenting in patient with suspected cerebral vasculitis: two case reports.

Authors :
Gabriele Vandelli
Laura Giacobazzi
Ludovico Ciolli
Maria Luisa Dell'Acqua
Laura Vandelli
Livio Picchetto
Francesca Rosafio
Giuseppe Maria Borzì
Riccardo Ricceri
Stefano Meletti
Stefano Vallone
Carlo Salvarani
Marco Sebastiani
Federico Sacchetti
Luca Verganti
Stefano Merolla
Gabriele Zelent
Guido Bigliardi
Source :
Case Reports in Neurology, Pp 1-1 (2023)
Publication Year :
2023
Publisher :
Karger Publishers, 2023.

Abstract

Central nervous system vasculitis (CNSV) is an uncommon and poorly understood form of vasculitis. Early recognition is important because medical treatment might improve the outcome. However, randomized clinical trials on CNSV treatment do not exist. Endovascular treatment has been reported in few cases, but no data exist for intracranial stenting. We report two cases of patients with suspected CNSV and recurrent clinical episodes, treated with intracranial stenting. A 48-year-old man had relapsing episodes of right hemiparesis. Neuroradiological exams showed severe left carotid terminus stenosis. Despite immunosuppressive therapy, neuroradiological follow-up exams showed a worsening of the aforementioned stenosis with many transient episodes of weakness in the right limbs and aphasia. A 64-year-old woman had a sudden onset of dysarthria and transient aphasia. Neuroradiological exams showed a severe arterial stenosis involving the origin of left ACA and MCA. Despite dual antiplatel therapy she presented an acute onset of severe aphasia, due to an occlusion of the left carotid terminus and proximal MCA. In both cases endovascular procedure and intracranial stenting was performed, with marked improvement of cerebral blood flow. No more clinical episodes were reported. Intracranial stenting may be a valid therapeutic option in selected patients with CNSV and involvement of medium or large size vessels with clinical worsening despite best medical treatment.

Details

Language :
English
ISSN :
1662680X
Database :
Directory of Open Access Journals
Journal :
Case Reports in Neurology
Publication Type :
Academic Journal
Accession number :
edsdoj.2044288656b24700bff3f8a76cbd16f7
Document Type :
article
Full Text :
https://doi.org/10.1159/000529942