Systemic Sarcoidosis Presenting with Headache and Stroke-Like Episodes

Author:

Campbell J.1,Kee R.1,Bhattacharya D.2,Flynn P.2,McCarron M.3,Fulton A.1

Affiliation:

1. Department of Neurology, Royal Victoria Hospital, Belfast BT12 6BA, UK

2. Department of Neuroradiology, Royal Victoria Hospital, Belfast BT12 6BA, UK

3. Neurology Centre, Altnagelvin Area Hospital, Londonderry BT47 6SB, UK

Abstract

Sarcoidosis is a multisystem granulomatous disorder. Neurological manifestations as a presenting symptom are relatively rare. A 26-year-old male presented with a five-week history of headache suggestive of raised intracranial pressure. He subsequently developed transient episodes of mild right-sided hemiparesis and numbness. Magnetic resonance imaging (MRI) of brain revealed widespread inflammatory white matter lesions, an ischaemic focus in the left corona radiata, and widespread microhaemorrhages consistent with a more diffuse vasculopathy. Serum angiotensin-converting enzyme (ACE) level was normal. Lumbar puncture revealed an elevated opening pressure (36 cmH2O) and inflammatory cerebrospinal fluid (CSF). Computerised tomography (CT) of chest, abdomen, and pelvis revealed widespread lymphadenopathy and biopsy of axillary lymph nodes revealed the presence of noncaseating granulomata in keeping with systemic sarcoidosis. The patient responded well to corticosteroids. This case highlights the importance of considering sarcoidosis to be a rare but potentially treatable cause of stroke in younger patients.

Publisher

Hindawi Limited

Subject

Immunology,Immunology and Allergy

Cited by 10 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Clinical Manifestations of Sarcoidosis;Sarcoidosis - Diagnosis, Research, and Therapy of a Granulomatous Disease of Unknown Etiology [Working Title];2023-08-16

2. Common Clinical and Molecular Pathways between Migraine and Sarcoidosis;International Journal of Molecular Sciences;2023-05-05

3. Headache as a Neurologic Manifestation of Systemic Disease;Current Treatment Options in Neurology;2022-01

4. Neurosarcoidosis Flare with Multifocal Restricted Diffusion: Stroke, Inflammation, or Both?;Journal of Stroke and Cerebrovascular Diseases;2018-10

5. Clinical, imaging, and histological presentations and outcomes of stroke related to sarcoidosis;Journal of Neurology;2018-08-14

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