CEREBRAL VASCULITIS IN AN ADOLESCENT WITH JUVENILE RHEUMATOID-ARTHRITIS

A 16-year-old girl with longstanding polyarticular juvenile rheumatoid arthritis was referred from Chuuk State, Federated States of Micrones ia, for evaluation and management of weakness and joint pains. She had a right hemiparesis with central facial weakness, polyarticular arthr itis, and a dense cataract of the left eye with phthisis bulbi, Extens ive evaluation using magnetic resonance angiography revealed vasculiti s of the anterior and middle cerebral arteries. She was treated with ' 'pulse'' doses of methylprednisolone intravenously and she improved re markably. Repeat angiography demonstrated dramatic improvement of the vasculitis. There is a paucity of literature regarding cerebral vascul itis in juvenile rheumatoid arthritis. That literature is reviewed, an d our patient is discussed with regard to the few published reports. ( C) 1998 by Elsevier Science Inc. All rights reserved.