RECOVERY FROM RHEUMATOID CEREBRAL VASCULITIS BY LOW-DOSE METHOTREXATE

We report the successful management of cerebral vasculitis in a 46-yea r-old woman with longstanding rheumatoid arthritis with low-dose metho trexate. She suddenly developed dysarthria and left hemiparesis. Magne tic resonance imaging disclosed ischemia of the right pons, and angiog raphy demonstrated cerebral vasculitis of vertebro-basilar arteries. T he vasculitis was refractory with high-dose steroid therapy, which had only transient clinical benefit, and evolution to the pontine infarct ion followed. Her clinical status showed marked improvement in associa tion with recovery of the vascular abnormalities after the initiation of the methotrexate therapy.