Status epilepticus complicating a hemorrhagic and ischemic stroke due to primary cerebral angiitis: A case report

Q4 Medicine

Radiology Case Reports Pub Date : 2025-04-12 DOI:10.1016/j.radcr.2025.03.038

Mehdi Oudrhiri Safiani , Abdallah Bennasser , Ahmed El Mostarchid , Mohamed Jiddane , Firdaous Touarsa

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引用次数: 0

Abstract

Primary angiitis of the central nervous system (CNS), also known as “isolated” or “idiopathic” angiitis, is a rare condition characterized by inflammation of cerebral vessels in the absence of an identifiable cause. This contrasts with secondary angiitis, which is associated with systemic diseases, infections, or toxic exposures. The clinical presentation of primary angiitis is highly variable and, in severe cases, may include ischemic or hemorrhagic strokes or refractory status epilepticus (SE).

We present a unique case of a 45-year-old female patient with a history of primary CNS angiitis, admitted to the intensive care unit for refractory SE secondary to concurrent ischemic and hemorrhagic strokes. This rare combination of SE, stroke, and CNS angiitis is exceptionally uncommon in the literature and underscores the diagnostic and therapeutic challenges of this condition. This case highlights potential pathophysiological mechanisms, diagnostic difficulties, and management strategies in a highly complex clinical scenario.

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原发性脑血管炎导致的出血性和缺血性中风并发癫痫状态：病例报告

原发性中枢神经系统脉管炎（CNS），也被称为“孤立性”或“特发性”脉管炎，是一种罕见的疾病，其特征是在没有可识别原因的情况下脑血管炎症。这与继发性脉管炎形成对比，后者与全身性疾病、感染或毒性暴露有关。原发性血管炎的临床表现变化很大，在严重的病例中，可能包括缺血性或出血性中风或难治性癫痫持续状态（SE）。我们提出一个独特的情况下，45岁的女性患者与原发性中枢神经系统脉管炎的历史，住进重症监护病房难治性SE继发并发缺血性和出血性中风。这种罕见的SE、中风和中枢神经系统血管炎的合并在文献中非常罕见，并强调了这种疾病的诊断和治疗挑战。本病例强调了在高度复杂的临床情况下潜在的病理生理机制、诊断困难和管理策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiology Case Reports Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

1.10

自引率

0.00%

发文量

1074

审稿时长

30 days

期刊介绍： The content of this journal is exclusively case reports that feature diagnostic imaging. Categories in which case reports can be placed include the musculoskeletal system, spine, central nervous system, head and neck, cardiovascular, chest, gastrointestinal, genitourinary, multisystem, pediatric, emergency, women''s imaging, oncologic, normal variants, medical devices, foreign bodies, interventional radiology, nuclear medicine, molecular imaging, ultrasonography, imaging artifacts, forensic, anthropological, and medical-legal. Articles must be well-documented and include a review of the appropriate literature.