TY - JOUR T1 - Multiple cerebral infarcts: a rare complication of neurosarcoidosis JF - Practical Neurology JO - Pract Neurol SP - 246 LP - 249 DO - 10.1136/practneurol-2018-002133 VL - 19 IS - 3 AU - Matthew John Harris AU - Mark Daniel Cossburn AU - George Pengas Y1 - 2019/06/01 UR - http://pn.bmj.com/content/19/3/246.abstract N2 - A 52-year-old man experienced a relapse of neurosarcoidosis, characterised by obstructive hydrocephalus and multiple posterior circulation infarcts. He was taking methotrexate, but his prednisolone was being weaned because of adverse effects. Stroke is rare in neurosarcoidosis and typically relates to granulomatous inflammation with a predilection for the perforator arteries. Sarcoidosis generally responds well to corticosteroids; however, patients with leptomeningeal involvement usually require additional immunosuppression as relapses can occur on weaning of corticosteroids. It is worth considering tumour necrosis factor-α antagonists for cases that progress despite first-line therapy. ER -