CENTRAL-NERVOUS-SYSTEM VASCULITIS

Central nervous system vasculitis occurs in a variety of clinical sett ings. Some exhibit a distinct age preference; others a tissue tropism. Most frequently encountered are giant cell arteritis (temporal arteri tis) and vasculitis secondary to infections. The central nervous syste m may be involved in the antineutrophil cytoplasmic antibody-associate d systemic vasculitides and occasionally neurologic abnormalities appe ar as a presenting manifestation of disease. Isolated angiitis of the central nervous system, a rare form of vasculitis that is restricted t o the central nervous system, must be distinguished from other causes of central nervous system inflammation and from noninflammatory vascul ar disease. We are learning a great deal about the cellular mechanisms of vascular inflammation in general. Some manifestations of the clini cal disease result from histologic features of the infiltrate and the size of affected vessel. However, the local consequences of inflammati on, such as increased coagulation and altered vasomotor tone, as well as the systemic consequences, such as activation of the central noradr energic systems, trigeminovascular system, and hypothalamic pituitary adrenal axis, contribute both to pathogenesis of disease and to recove ry. Curr Opin Neurol 11:241-246. (C) 1998 Lippincott-Raven Publishers.