T. Koide et al., Cyclosporine A-associated fatal central nervous system angiopathy in a bone marrow transplant recipient: an autopsy case, ACT NEUROP, 99(6), 2000, pp. 680-684
We report here the case of a 32-year-old woman who suffered from a unique a
ngiopathy in the central nervous system (CNS). She died of multiple infarct
s in the brain stem and cerebellum during treatment with cyclosporine A aft
er bone marrow transplantation for refractory anemia with excess of blasts.
The autopsy findings showed segmental narrowing of the basilar artery, in
which circumferential dissection of the internal elastic lamina had occurre
d. The distal portion of the basilar artery was obstructed by upward disloc
ation of the dissected intima. Similar angiopathy was also observed at mult
iple sites along the basilar artery branches. These findings suggest endoth
elial damage, including vasoconstriction and dissection of the CNS arteries
.