ISOLATED ANGIITIS OF THE CNS PRESENTING AS SUBARACHNOID HEMORRHAGE

Isolated angiitis of the CNS (IACNS) commonly presents with recurrent ischaemic or haemorrhagic infarcts, but subarachnoid haemorrhage is ra re. Three patients with IACNS and subarachnoid haemorrhage are reporte d. Florid granulomatous angiitis with Langhans and foreign body type g iant cells was found at necropsy in a child with sudden death. In two other patients the diagnosis was made angiographically. In one patient multifocal infarcts on MRI became evident one week after subarachnoid haemorrhage despite initial treatment with prednisone. Subarachnoid h aemorrhage may be the first presentation of IACNS. Characteristic radi ographic findings may allow early diagnosis.