Microscopic polyangiitis associated with antineutrophil cytoplasmic antibodies directed against myeloperoxidase rarely affects the central nervous system, and this is common in the presence of other organ involvement. The authors report the case of a 12-year-old girl who presented with multiple acute parieto-occipital hematomas as the only manifestation of presumed microscopic polyangiitis. Early treatment with immunosuppression resulted in complete recovery and a favorable outcome.
SasakiAHiratoJNakazatoYTanakaTTakeuchiH. An autopsy case of pANCA-positive microscopic polyangiitis with multiple cerebral hemorrhagic infarctions. No To Shinkei. 1998;50:56–60.
3.
ItoYSuzukiKYamazakiTYoshizawaTOhkoshiNMatsumuraA. ANCA associated vasculitis (AAV) causing bilateral cerebral infarction and subsequent intracerebral hemorrhage without renal and respiratory dysfunction. J Neurol Sci. 2006;240:99–101.
4.
QureshiAIEzzeddineMANasarA. Prevalence of elevated blood pressure in 563,704 adult patients with stroke presenting to the ED in the United States. Am J Emerg Med. 2007;25:32–38.
5.
Hajj-AliRASinghalABBenselerS. Primary angiitis of the CNS. Lancet Neurol. 2011;10:561–572.
6.
MencacciNEBersanoACinnanteCM. Intracerebral haemorraghe, a possible presentation in Churg-Strauss syndrome: case report and review of the literature. J Neurol Sci. 2011;301:107–111.
7.
SassiSBGhorbelIBMizouniH. Microscopic polyangiitis presenting with peripheral and central neurologic manifestations. Neurol Sci. 2011;32:727–729.
8.
HondaHHasegawaTMorokawaN. A case of MPO-ANCA related vasculitis with transient leukoencephalopathy and multiple cerebral hemorrhage. Rinsho Shinkeigaku. 1996;36:1089–1094.
9.
HanSRehmanHUJayaratnePS. Microscopic polyangiitis complicated by cerebral haemorrhage. Rheumatol Int. 2006;26:1057–1060.
10.
HutchinsonCElbersJHallidayW. Treatment of small vessel primary CNS vasculitis in children: an open-label cohort study. Lancet Neurol. 2010;9:1078–1084.
11.
CuppsTRMoorePMFauciAS. Isolated angiitis of the central nervous system: prospective diagnostic and therapeutic experience. Am J Med. 1983;74:97–105.