Systemic Sarcoidosis Presenting with Headache and Stroke-Like Episodes

Sarcoidosis is a multisystem granulomatous disorder. Neurological manifestations as a presenting symptom are relatively rare. A 26-year-old male presented with a five-week history of headache suggestive of raised intracranial pressure. He subsequently developed transient episodes of mild right-sided...

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Main Authors: J. Campbell, R. Kee, D. Bhattacharya, P. Flynn, M. McCarron, A. Fulton
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Immunology
Online Access:http://dx.doi.org/10.1155/2015/619867
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author J. Campbell
R. Kee
D. Bhattacharya
P. Flynn
M. McCarron
A. Fulton
author_facet J. Campbell
R. Kee
D. Bhattacharya
P. Flynn
M. McCarron
A. Fulton
author_sort J. Campbell
collection DOAJ
description Sarcoidosis is a multisystem granulomatous disorder. Neurological manifestations as a presenting symptom are relatively rare. A 26-year-old male presented with a five-week history of headache suggestive of raised intracranial pressure. He subsequently developed transient episodes of mild right-sided hemiparesis and numbness. Magnetic resonance imaging (MRI) of brain revealed widespread inflammatory white matter lesions, an ischaemic focus in the left corona radiata, and widespread microhaemorrhages consistent with a more diffuse vasculopathy. Serum angiotensin-converting enzyme (ACE) level was normal. Lumbar puncture revealed an elevated opening pressure (36 cmH2O) and inflammatory cerebrospinal fluid (CSF). Computerised tomography (CT) of chest, abdomen, and pelvis revealed widespread lymphadenopathy and biopsy of axillary lymph nodes revealed the presence of noncaseating granulomata in keeping with systemic sarcoidosis. The patient responded well to corticosteroids. This case highlights the importance of considering sarcoidosis to be a rare but potentially treatable cause of stroke in younger patients.
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spelling doaj-art-df449b7ba94e4a598843a367bdd4a6642025-08-20T03:26:25ZengWileyCase Reports in Immunology2090-66092090-66172015-01-01201510.1155/2015/619867619867Systemic Sarcoidosis Presenting with Headache and Stroke-Like EpisodesJ. Campbell0R. Kee1D. Bhattacharya2P. Flynn3M. McCarron4A. Fulton5Department of Neurology, Royal Victoria Hospital, Belfast BT12 6BA, UKDepartment of Neurology, Royal Victoria Hospital, Belfast BT12 6BA, UKDepartment of Neuroradiology, Royal Victoria Hospital, Belfast BT12 6BA, UKDepartment of Neuroradiology, Royal Victoria Hospital, Belfast BT12 6BA, UKNeurology Centre, Altnagelvin Area Hospital, Londonderry BT47 6SB, UKDepartment of Neurology, Royal Victoria Hospital, Belfast BT12 6BA, UKSarcoidosis is a multisystem granulomatous disorder. Neurological manifestations as a presenting symptom are relatively rare. A 26-year-old male presented with a five-week history of headache suggestive of raised intracranial pressure. He subsequently developed transient episodes of mild right-sided hemiparesis and numbness. Magnetic resonance imaging (MRI) of brain revealed widespread inflammatory white matter lesions, an ischaemic focus in the left corona radiata, and widespread microhaemorrhages consistent with a more diffuse vasculopathy. Serum angiotensin-converting enzyme (ACE) level was normal. Lumbar puncture revealed an elevated opening pressure (36 cmH2O) and inflammatory cerebrospinal fluid (CSF). Computerised tomography (CT) of chest, abdomen, and pelvis revealed widespread lymphadenopathy and biopsy of axillary lymph nodes revealed the presence of noncaseating granulomata in keeping with systemic sarcoidosis. The patient responded well to corticosteroids. This case highlights the importance of considering sarcoidosis to be a rare but potentially treatable cause of stroke in younger patients.http://dx.doi.org/10.1155/2015/619867
spellingShingle J. Campbell
R. Kee
D. Bhattacharya
P. Flynn
M. McCarron
A. Fulton
Systemic Sarcoidosis Presenting with Headache and Stroke-Like Episodes
Case Reports in Immunology
title Systemic Sarcoidosis Presenting with Headache and Stroke-Like Episodes
title_full Systemic Sarcoidosis Presenting with Headache and Stroke-Like Episodes
title_fullStr Systemic Sarcoidosis Presenting with Headache and Stroke-Like Episodes
title_full_unstemmed Systemic Sarcoidosis Presenting with Headache and Stroke-Like Episodes
title_short Systemic Sarcoidosis Presenting with Headache and Stroke-Like Episodes
title_sort systemic sarcoidosis presenting with headache and stroke like episodes
url http://dx.doi.org/10.1155/2015/619867
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