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Subacute cognitive impairment as clinical presentation of primary angiitis of the central nervous system
Deterioro cognitivo subagudo como comienzo de una angeítis primaria del sistema nervioso central
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"Vilar-Fabra" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Neurología, Hospital General Universitario de Castellón, Castellón de la Plana, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital General Universitario de Castellón, Castellón de la Plana, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Deterioro cognitivo subagudo como comienzo de una angeítis primaria del sistema nervioso central" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 923 "Ancho" => 900 "Tamanyo" => 128719 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">An 81-year-old man was evaluated in the neurology department of our center for a 4-week history of cognitive impairment and generalized weakness. The patient did not associate headache, other neurological deficits, or systemic involvement.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A magnetic resonance imaging (MRI) study was performed, which showed a lesion in the corpus callosum (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A) that decreased in size during his 6-month follow-up (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). However, 18 months later, new lesions appeared in the left frontal lobe and a large lesion in the right temporal lobe with a mass effect and contrast uptake (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B and <span class="elsevierStyleSmallCaps">C</span>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Laboratory tests including systematic analysis, serologies and angiotensin converting enzyme levels were normal. An electroencephalogram was performed, which was normal. Given the nonspecific clinical presentation, the progression and the neuroimaging findings, an inflammatory process was suspected, so a biopsy of the lesion was scheduled.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Brain biopsy (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) showed chronic inflammatory involvement of the intracerebral and leptomeningeal blood vessels (black arrows) in and around the blood vessel walls (white arrows) confirming the diagnosis of primary angiitis of the central nervous system.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">No funding has been received for the completion of this article.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Barea-Moya L, Mateo-Casas M, Aparicio-Collado H, Segura-Cerdá A, Grande-González R, Mengual-García ME, et al. Deterioro cognitivo subagudo como comienzo de una angeítis primaria del sistema nervioso central. 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