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Cerebral Vasculitis: A Practical Approach
  1. F G. Joseph,
  2. N J. Scolding
  1. University of Bristol, Institute of Clinical Neurosciences, Department of Neurology, Frenchay Hospital, Bristol BS16 1LE UK; Email: N.J.Scolding{at}tesco.net

    Abstract

    INTRODUCTION

    The range and breadth of diseases of the nervous system caused by immunological or inflammatory disturbances is enormous (Table 1). ‘Primary’ or idiopathic neuroimmune disorders may affect any part of the neuraxis and they are, of course, very familiar to neurologists. ‘Secondary’ disorders, where the neurological disturbance reflects involvement of the nervous system in a systemic inflammatory disease, are often no less common than idiopathic neuroimmune disorders, but most neurologists are rather less familiar and possibly less comfortable in dealing with them. Here we confine ourselves to the vasculitic disorders, and concentrate only on cerebral disease.

    The vasculitides are a heterogeneous group of diseases characterised by blood vessel inflammation, with different but frequently overlapping clinical and pathological manifestations (Watts et al. 1997). The classical histopathological change is modified in characteristic ways in specific syndromes (see below), but essentially consists of an inflammatory infiltrate within the vessel wall associated with

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