Primary angiitis of the central nervous system (PACNS): investigations
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Primary angiitis of the central nervous system (PACNS): investigations. Multiple bilateral high signal changes. Fully referenced neurology checklist.
Magnetic resonance imaging (MRI) brain: features
- Multiple bilateral high signal changes
- Multiple cortical-subcortical infarcts
- Mass lesions
- Confluent white matter changes
- Intracerebral haemorrhage (ICH)
- Subarachnoid haemorrhage (SAH)
- Cortical microhaemorrhages: with small vessel PACNS
- Radial linear contrast enhancement: case report
- Leptomeningeal enhancement
- The abnormalities may be uni-hemispheric
- The thalamus may be prominently involved
Cerebrospinal fluid (CSF) analysis
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Cerebral angiography
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Brain biopsy
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References
- Binbaum J, Hellmann DB. Primary angiitis of the central nervous system. Arch Neurol 2009; 66:704-709.
- Rehman HU. Primary angiitis of the central nervous system. J R Soc Med 2000; 93:586-588.
- Hajj-Ali RA, Singhal AB, Benseler S, Molloy E, Calabrese LH. Primary angiitis of the CNS. Lancet Neurol 2011; 10:561-572.
- Molloy ES, Singhal AB, Calabrese LH. Tumour-like mass lesion: an under-recognised presentation of primary angiitis of the central nervous system. Ann Rheum Dis 2008; 67:1732-1735.
- Guo A, Zhang Z, Dong GH, et al. Cortical microhemorrhage presentation of small vessel primary angiitis of the central nervous system. Ann Neurol 2024; 96:194-203.
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