Navigation Links
Mayo Clinic clarifies diagnosis for serious blood vessel disease of brain and spinal cord
Date:10/18/2007

ROCHESTER, Minn. -- Mayo Clinic has clarified the methods of diagnosis and optimal management of a rare and little-understood blood vessel disease of the brain and spinal cord that often leads to stroke or death. Primary central nervous system vasculitis (PCNSV) can best be identified through a combination of diagnostic techniques consisting of angiography (imaging the cerebral arteries), brain biopsy and other laboratory studies.

This disease is often suspected based on a combination of symptoms, along with the initial results of brain imaging with CT or MRI. The Mayo study clarifies the usefulness of the evaluation techniques and suggests that a combined diagnostic approach is needed. Primary central nervous system vasculitis is difficult to diagnose because it is not a single disease, but a variable syndrome that appears to consist of several distinct subsets of different diseases that can mimic other less-serious conditions, thus eluding treatment. Frequent symptoms are headache, altered cognition, or stroke, and visual symptoms. Recognizing the symptoms and understanding the role of evaluation techniques, may lead to earlier identification and treatment of patients.

This Mayo Clinic analysis of 101 patients seen with primary central nervous system vasculitis over 21 years represents one of the largest reported groups of patients with this disorder. The Mayo Clinic research report on improved understanding of PCNSV appears in the current edition of Annals of Neurology (http://www3.interscience.wiley.com/cgi-bin/jissue/78504407).

Significance of the Mayo Clinic Research

Primary central nervous system vasculitis has two traits that make it difficult, yet important, to study:

  • It is rare and poorly understood. Few medical centers see enough patients with confirmed diagnoses to collect enough data to analyze.

  • It carries a high potential for serious complications, even death. A blood vessel that malfunctions may disrupt blood supply and oxygen to the brain or spinal cord, leading to a stroke.

While angiography has been the preferred diagnostic technique because it is less invasive and carries fewer risks than brain biopsy, no studies had determined its accuracy or established angiographic criteria for the diagnosis. Progress in understanding PCNSV has been slow because its occurrence is infrequent and its identification is difficult, explains Robert D. Brown Jr., M.D., chair of the Mayo Clinic Department of Neurology, and the lead investigator. Our study begins to answer some essential questions that can clarify diagnosis and hopefully lead to earlier, and successful, management.

Symptoms and Treatment

Patients with PCNVS in the Mayo Clinic study had the following symptoms: headache was the most common, followed by changes in ability to think or remember (cognitive impairment); weakness on one side of the body; and difficulty speaking (aphasia). Of the 101 patients, 97 were prescribed initial treatment consisting of oral or intravenous doses of the steroid drug prednisone; some received oral or intravenous doses of the chemotherapy drug cyclophosphamide. Most showed favorable responses. This encouraging finding emphasizes the need for early diagnosis and initiation of therapy that may help avoid serious and irreversible complications, says Dr. Brown.

Key Findings

Some the studys main findings:

  • Angiography imaging of blood vessels appears to complement brain biopsy in determining diagnosis.

  • PCNSV is not a single disease, but a variable syndrome that appears to consist of several distinct subsets of different diseases.

  • Though treatment is available and most patients responded to therapy, relapse was common, occurring in 25 percent of patients studied.

  • Death and disability rates among patients were highest in those who had a defined brain dysfunction, such as cognitive impairment, stroke and disease of the large blood vessels on angiography.

  • The annual incidence rate of primary central nervous system vasculitis was 2.4 cases per 1 million people.

Collaboration and Support

Other members of the Mayo Clinic research team include Carlo Salvarani, M.D.; Kenneth Calamia, M.D.; Teresa Christianson; Stephen Weigand; Dylan Miller, M.D.; Caterina Giannini, M.D.; James Meschia, M.D.; John Huston III, M.D.; and Gene Hunder, M.D. Their work was supported with grants from Mayo Foundation for Medical Education and Research.


'/>"/>

Contact: Carol Lammers
newsbureau@mayo.edu
507-284-5005
Mayo Clinic
Source:Eurekalert

Related medicine news :

1. Scientists plan human cloning clinic in the United States
2. How do patients benefit of clinical trials
3. Magnetic resonance angiography in clinical medicine
4. Clinical trials need to be more frank
5. AEternas acquisition of Zentaris being followed up with its new product pipeline and clinical development strategy
6. Physicians Lack Clinical Guidelines For Treating Elderly With Multiple Illnesses
7. The Growing Rise In Clinical Research Could Lead To A Compromise In Quality Of Research And Ethics
8. Clinical Comparisons Between ADHD Drugs Are Less
9. Specialized Clinics For Manipurs AIDS Patients
10. Outsourcing clinical trials to India
11. Erectile dysfunction: an early warning sign of clinically silent coronary artery disease?
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/23/2017)... ... March 23, 2017 , ... After raising more than $1.135 million ($1,479,231 AUD) ... travel pillow in crowdfunding history, has established a U.S. Headquarters in New York ... to Americans. , “We’re excited to be operating on U.S. shores, where most of ...
(Date:3/23/2017)... ... ... conference will prominently feature 150+ Hospital and Health System Executive Speakers including: , ... 43rd President of the United States of America: George W. Bush , ... the Ring: Sugar Ray Leonard , JD, Chairperson, McGuireWoods LLP: Amber McGraw Walsh ...
(Date:3/23/2017)... ... March 23, 2017 , ... Sharon Kleyne, host of the nationally syndicated ... Health on VoiceAmerica, recently talked on her program about how she is looking forward ... remind listeners of an important distinction. World Water Day, Kleyne pointed out, is an ...
(Date:3/23/2017)... ... March 23, 2017 , ... ... help improve all aspects of people’s health and nutrition, announced its product Leyzene ... , Natural Subsistence develops nutritional supplements that help people improve all aspects ...
(Date:3/23/2017)... ... ... Inflow IQ & Inflownomics of Raleigh, NC introduce a powerful information access network. ... experts in dangerous situations the Inflow IQ team can help people. Get ready ... & refreshing knowledge systems that enhance life. , Authentically enjoy 500 ...
Breaking Medicine News(10 mins):
(Date:3/23/2017)... 2017  Ethicon* today announced the completion of ... held medical device company that manufactures and markets ... treatment of Gastroesophageal Reflux Disease (GERD). This acquisition ... portfolio of minimally invasive options for patients suffering ... of the transaction have not been disclosed. ...
(Date:3/23/2017)... YORK , March 23, 2017 ... sample preparation market is expected to reach USD 7.2 billion ... of 7.1%. Sample preparation is a procedure in which a ... crucial step in most analytical procedures since the methods are ... preparation is one of the most shared procedures in the ...
(Date:3/23/2017)... 2017  Drug diversion is a significant contributing ... overdoses. A new oral fluid monitoring test, announced ... reports more detailed and actionable information to clinicians ... therapy adherence, patient safety, and help to identify ... fluid Rx Evaluation (CORE) system is the first ...
Breaking Medicine Technology: