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NEUROIMAGE
Year : 2022  |  Volume : 70  |  Issue : 2  |  Page : 839-840

Cerebral Angiography of Eosinophilic Granulomatosis with Polyangiitis


Department of Neurology, Ina Central Hospital, 1313-1, Ina, Nagano, Japan

Date of Submission27-Aug-2020
Date of Decision17-Jan-2021
Date of Acceptance29-Jan-2021
Date of Web Publication3-May-2022

Correspondence Address:
Dr. Yuya Kobayashi
Department of Neurology, Ina Central Hospital, 1313-1, Ina, Nagano, 396-8555
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.344617

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How to cite this article:
Kobayashi Y, Morizumi T, Nagamatsu K, Shimizu Y. Cerebral Angiography of Eosinophilic Granulomatosis with Polyangiitis. Neurol India 2022;70:839-40

How to cite this URL:
Kobayashi Y, Morizumi T, Nagamatsu K, Shimizu Y. Cerebral Angiography of Eosinophilic Granulomatosis with Polyangiitis. Neurol India [serial online] 2022 [cited 2022 Jun 25];70:839-40. Available from: https://www.neurologyindia.com/text.asp?2022/70/2/839/344617




A 69-year-old woman was hospitalized with headache. Eosinophilic granulomatosis with polyangiitis (EGPA) was diagnosed based on asthma, ground-glass opacification observed upon lung CT imaging, elevated eosinophilia (1230/μL, 15% of total white blood cell), and sinusitis. Her headache was focused on the left of the nose. Magnetic resonance imaging and angiography showed no abnormalities such as stroke or hypertrophic pachymeningitis. Digital subtraction angiography (DSA) was performed before and after treatment. Spasm was detected on the intracranial peripheral artery and painful nose area. She was treated with steroids; pain and spasm improved [Figure 1].
Figure 1: (a and b) The image shows DSA of the left common carotid artery. Compared to post-treatment, pretreatment DSA exhibits intracranial peripheral arteries that are narrow and takes longer for visualization than the occipital artery. The distal arteries of the maxillary artery are not clearly visualized. c and d) The region distal to the maxillary artery was magnified and imaged; the pretreatment image contrast is increased for easier visualization. The infraorbital and sphenopalatine arteries show spasm (red circled area) and contrast agent pooling in the capillary phase is not observed

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Evaluation of peripheral blood vessels, especially of those in the nasal region surrounded by bones, is difficult using methods other than DSA. EGPA causes vasculitis with eosinophil infiltration, including within brain arteries.[1] Cerebral infarction occurs in 7% of EGPA cases and can cause enlarged sequelae. [2] DSA can be used as reference for treatment and discovery of headache causes.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Kenichiro H, Hideki S, Riyu K, Masashi T, Akane H, Keiji T, et al. Multiple cerebral infarction diagnosed as Eosinophilic Granulomatosis with Polyangiitis by autopsy. BMC Neurol 2019;19:288.  Back to cited text no. 1
    
2.
Guillevin L, Cohen P, Gayraud M, Lhote F, Jarrousse B, Casassus P. Churg-Strauss syndrome. Clinical study and long-term follow-up of 96 patients. Medicine (Baltimore) 1999;78:26-37.  Back to cited text no. 2
    


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