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Rheumatoid meningitis with yellowish‐white matter on the brain surface
Author(s) -
Tsunogae Marie,
Fujiwara Satoru,
Shigeyasu Masashi,
Sasaki Natsuhi,
Shimizu Yuri,
Hara Shigeo,
Kohara Nobuo
Publication year - 2020
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12424
Subject(s) - medicine , white matter , rheumatoid arthritis , hyperintensity , meningitis , magnetic resonance imaging , brain biopsy , pathological , etiology , subarachnoid space , pathology , radiology , surgery , cerebrospinal fluid
Abstract A 68‐year‐old man presented with a 3‐month history of progressive cognitive impairment. His brain magnetic resonance imaging showed multiple hyperintense lesions in the subarachnoid space, which suggested leptomeningitis. A brain biopsy was performed, and we found a yellowish‐white matter spread on his brain surface. Although the pathological evaluation did not lead to the diagnosis, steroid therapy improved his symptoms in five weeks. However, concomitantly with steroid tapering, his cognitive dysfunction relapsed and he developed swelling of finger joints consistent with rheumatoid arthritis, and then, we finally diagnosed him with rheumatoid meningitis. The characteristic yellowish‐white matter on the brain surface might be helpful for investigating the cause of leptomeningitis with unknown etiology.