Premium
An Unusual Presentation of Rheumatoid Meningitis
Author(s) -
Chowdhry Vaidehi,
Kumar Neeraj,
Lachance Daniel H.,
Salomao Diva R.,
Luthra Harvinder S.
Publication year - 2005
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/j.1552-6569.2005.tb00325.x
Subject(s) - medicine , rheumatoid arthritis , headaches , brain biopsy , arteritis , biopsy , meningitis , giant cell arteritis , magnetic resonance imaging , central nervous system , pathology , dermatology , vasculitis , radiology , disease , surgery
Background . Central nervous system involvement in rheumatoid arthritis can rarely occur in the absence of systemic disease. Rheumatoid meningitis has not been reported to present as spells of neurologic dys‐function. Patient and Methods . The authors describe a woman with a history of well‐controlled rheumatoid arthritis who presented with headaches and spells of focal neurological dysfunction. Brain magnetic resonance imaging, brain biopsy, and temporal artery biopsy were required to make the diagnosis of rheumatoid meningitis with arteritis. Results . Neuroimaging revealed abnormal leptomeningeal enhancement. Necrotizing granulomatous inflammation was seen on meningeal and brain biopsy. A temporal artery biopsy showed evidence of arteritis without giant cells. Conclusions . The possibility of central nervous system involvement by rheumatoid arthritis should be considered in patients with a history of rheumatoid arthritis even in the absence of systemic symptoms. Making the diagnosis may require meningeal and brain biopsy. The condition may be steroid responsive.