Primary angiitis of the central nervous system: Experience of a Victorian tertiary-referral hospital

Journal article


Oon, S., Roberts, Carol, Gorelik, Alexandra, Wicks, I. and Brand, Caroline A.. (2013). Primary angiitis of the central nervous system: Experience of a Victorian tertiary-referral hospital. Internal Medicine Journal. 43(6), pp. 685 - 692. https://doi.org/10.1111/imj.12038
AuthorsOon, S., Roberts, Carol, Gorelik, Alexandra, Wicks, I. and Brand, Caroline A.
Abstract

Background: Primary angiitis of the central nervous system is a rare condition, which is often difficult to diagnose and is associated with significant morbidity and mortality. There is no standardised treatment protocol or randomised clinical trial evidence to guide management. Aim: To describe the clinical features, diagnostic modalities, treatment and outcomes in an Australian hospital population‐based series of primary cerebral angiitis. Methods: Data were collected via retrospective medical record review of patients with primary angiitis of the central nervous system for the period 1 July 1998 to 30 June 2009, using previously published diagnostic criteria. Eligible patient records were identified in two ways; from routinely collected hospital episode data, coded using the ICD‐10‐AM coding standard and by review of cerebral biopsy data. Results: Ten of 12 included patients had a positive cerebral biopsy, with two patients diagnosed by angiography. Mean age at diagnosis was 47.2 years (range 18–73 years), with a female predominance of 5:1. Headache was the most common symptom experienced. Seventy per cent of the biopsy specimens showed a lymphocytic vasculitis. All patients received treatment with either steroids alone or a combination of steroids and cyclophosphamide, the latter treatment being initiated for those with a higher modified Rankin score of disability. Nine (75%) responded to treatment. There was one in‐hospital death, and two patients had no documented response to treatment. Conclusion: This study presents the first Australian case series data of primary cerebral angiitis. Better understanding of management and outcomes of this rare condition would be gained through multicentre studies.

Keywordsprimary angiitis of the central nervous system; cerebral vasculitis; brain biopsy; cerebral angiography; immunosuppression
Year2013
JournalInternal Medicine Journal
Journal citation43 (6), pp. 685 - 692
PublisherWiley-Blackwell
ISSN1444-0903
Digital Object Identifier (DOI)https://doi.org/10.1111/imj.12038
Scopus EID2-s2.0-84879007991
Page range685 - 692
Publisher's version
File Access Level
Controlled
Place of publicationAustralia
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Posterior retroperitoneoscopic adrenalectomy: Outcomes and lessons learned from initial 50 cases
Cabalag, Miguel S., Mann, G. Bruce, Gorelik, Alexandra and Miller, Julie A.. (2015). Posterior retroperitoneoscopic adrenalectomy: Outcomes and lessons learned from initial 50 cases. ANZ Journal of Surgery. 85(6), pp. 478 - 482. https://doi.org/10.1111/ans.12508
Clinical feasibility of interactive motion-controlled games for stroke rehabilitation
Bower, Kelly, Louie, Julie, Landesrocha, Yoesph, Seedy, Paul, Gorelik, Alexandra and Bernhardt, Julie. (2015). Clinical feasibility of interactive motion-controlled games for stroke rehabilitation. Journal of NeuroEngineering and Rehabilitation (online). 12, pp. 1 - 12. https://doi.org/10.1186/s12984-015-0057-x
Physical therapists as primary practitioners in the emergency department: Six-month prospective practice analysis
de Gruchy, Adam, Granger, Catherine L. and Gorelik, Alexandra. (2015). Physical therapists as primary practitioners in the emergency department: Six-month prospective practice analysis. Physical Therapy. 95(9), pp. 1207 - 1216. https://doi.org/10.2522/ptj.20130552
Obesity is associated with retinopathy and macrovascular disease in type 1 diabetes
Price, Sarah A., Gorelik, Alexandra, Fourlanos, Spiros, Colman, Peter G. and Wentworth, John M.. (2014). Obesity is associated with retinopathy and macrovascular disease in type 1 diabetes. Obesity Research and Clinical Practice. 8(2), pp. e178 - e182. https://doi.org/10.1016/j.orcp.2013.03.007
IDH1 mutation is associated with seizures and protoplasmic subtype in patients with low-grade gliomas
Liubinas, Simon V., D'Abaco, Giovanna M., Moffat, Bradford M., Gonzales, Michael, Feleppa, Frank, Nowell, Cameron J., Gorelik, Alexandra, Drummond, Katharine J., O'Brien, Terence J., Kaye, Andrew H. and Morokoff, Andrew P.. (2014). IDH1 mutation is associated with seizures and protoplasmic subtype in patients with low-grade gliomas. Epilepsia. 55(9), pp. 1438 - 1443. https://doi.org/10.1111/epi.12662
Lifetime risk of total knee replacement and temporal trends in incidence by health care setting, socioeconomic status, and geographic location
Bohensky, Megan A., Ackerman, Ilana, Desteiger, Richard, Gorelik, Alexandra and Brand, Caroline A.. (2014). Lifetime risk of total knee replacement and temporal trends in incidence by health care setting, socioeconomic status, and geographic location. Arthritis Care and Research. 66(3), pp. 424 - 431. https://doi.org/10.1002/acr.22122
Lifetime risk of total hip replacement surgery and temporal trends in utilization: A population-based analysis
Bohensky, Megan A., Ackerman, Ilana, De Steiger, Richard, Gorelik, Alexandra and Brand, Caroline A.. (2014). Lifetime risk of total hip replacement surgery and temporal trends in utilization: A population-based analysis. Arthritis Care and Research. 66(8), pp. 1213 - 1219. https://doi.org/10.1002/acr.22279
Outcomes of ambulatory rehabilitation programmes following botulinum toxin for spas ticity in adults with stroke
Demetrios, Marina, Gorelik, Alexandra, Louie, Julie, Brand, Caroline A., Baguley, Ian J. and Khan, Fary. (2014). Outcomes of ambulatory rehabilitation programmes following botulinum toxin for spas ticity in adults with stroke. Journal of Rehabilitation Medicine. 46(8), pp. 730 - 737. https://doi.org/10.2340/16501977-1842
Drug-induced hepatotoxicity: Incidence of abnormal liver function tests consistent with volatile anaesthetic hepatitis in trauma patients
Lin, Jonathan, Moore, David, Hockey, Brad, Di Lernia, Rachel, Gorelik, Alexandra, Liew, Danny and Nicoll, Amanda J.. (2014). Drug-induced hepatotoxicity: Incidence of abnormal liver function tests consistent with volatile anaesthetic hepatitis in trauma patients. Liver International. 34(4), pp. 576 - 582. https://doi.org/10.1111/liv.12278
Predictors of health care use among patients with or at high risk of atherothrombotic disease: Two-year follow-up data
Ademi, Zanfina, Liew, Danny, Gorelik, Alexandra, Bohensky, Megan A., Zomer, Ella, Hollingsworth, Bruce, Steg, Gabriel, Bhatt, Deepak L. and Reid, Christopher M.. (2014). Predictors of health care use among patients with or at high risk of atherothrombotic disease: Two-year follow-up data. International Journal of Cardiology. 175(1), pp. 72 - 77. https://doi.org/10.1016/j.ijcard.2014.04.230
Long term follow-up after aortic valve replacement (Ross Procedure): Echocardiographic determinants of ventricular recovery
Wilson, William M., Grigg, Leeanne E., Gorelik, Alexandra and Skillington, Peter. (2014). Long term follow-up after aortic valve replacement (Ross Procedure): Echocardiographic determinants of ventricular recovery. Heart, Lung and Circulation. 23(2), pp. 132 - 143. https://doi.org/10.1016/j.hlc.2013.07.008
Geographical variation in incidence of knee arthroscopy for patients with osteoarthritis: A population-based analysis of Victorian hospital separations data
Bohensky, Megan A., Barker, Anna, Morello, Renata Teresa, De Steiger, Richard N., Gorelik, Alexandra and Brand, Caroline A.. (2014). Geographical variation in incidence of knee arthroscopy for patients with osteoarthritis: A population-based analysis of Victorian hospital separations data. Internal Medicine Journal. 44(6), pp. 537 - 545. https://doi.org/10.1111/imj.12438
Thyroid surgery and anticoagulation: Survey of practice of endocrine surgeons in Australia
Verma, Kunal Pradip, Gorelik, Alexandra and Miller, Julie A.. (2013). Thyroid surgery and anticoagulation: Survey of practice of endocrine surgeons in Australia. World Journal of Endocrine Surgery. 5(1), pp. 6 - 11. https://doi.org/10.5005/jp-journals-10002-1115
Outcomes and excess costs among patients with cardiovascular disease
Ademi, Zanfina, Liew, Danny, Zomer, Ella, Gorelik, Alexandra, Hollingsworth, Bruce, Steg, Philippe Gabriel, Bhatt, Deepak L. and Reid, Christopher M.. (2013). Outcomes and excess costs among patients with cardiovascular disease. Heart, Lung and Circulation. 22(9), pp. 724 - 730. https://doi.org/10.1016/j.hlc.2013.02.002
Epidemiology of hepatitis B-associated hepatocellular carcinoma in Victoria
Sinclair, M., Roberts, S., Kemp, W., Knight, V., Dev, A., Gow, P., Philpott, H., Kronborg, Ian, Arachchi, Niranjan J., Bell, Sally J., Lim, Lucy, Gorelik, Alexandra and Nicoll, Amanda J.. (2013). Epidemiology of hepatitis B-associated hepatocellular carcinoma in Victoria. Internal Medicine Journal. 43(5), pp. 501 - 506. https://doi.org/10.1111/imj.12068
Who, why and when: Stroke care unit patients seen by a palliative care service within a large metropolitan teaching hospital
Eastman, Peter, McCarthy, Gillian, Brand, Caroline A., Weir, Louise, Gorelik, Alexandra and Le, Brian. (2013). Who, why and when: Stroke care unit patients seen by a palliative care service within a large metropolitan teaching hospital. BMJ Supportive and Palliative Care. 3(1), pp. 77 - 83. https://doi.org/10.1136/bmjspcare-2012-000331