BACKGROUND: @entity1333 of the central nervous system is rare but well described. It affects the cerebral hemispheres predominantly and only exceptionally involves the spinal cord. OBJECTIVE: To describe a case of @entity602 with unusual pathologic changes. DESIGN: Case report with clinicopathologic correlation. Case Description A young @entity1 developed @entity425 and sensory symptoms over several weeks. He had an asymmetric paraparesis with impaired vibration sense in the feet and a Romberg sign but no sensory level. The cerebrospinal fluid contained 123 white blood cells x103/ micro L, mostly lymphocytes, and a protein concentration of 52 mg/dL; oligoclonal bands were not detected, but the illness simulated @entity15 . Magnetic resonance imaging scans of the spinal cord and brain were normal. His condition improved on several occasions with intravenous infusions of corticosteroid agents, but his neurologic signs gradually worsened over several months, and he acquired a thoracic sensory level and @entity1690 . An explosive @entity221 occurred with @entity451 , @entity346 , and @entity772 . The findings of a pathologic examination showed numerous ischemic areas in the spinal cord, some cavitated, and a @entity1333 of the leptomeningeal branches of the anterior spinal artery and of subpial vessels. The vessel walls were not necrotic, but many of their lumens were occluded by fibrinous material. There were similar findings in regions of cerebral @entity385 . CONCLUSIONS: A destructive and vasculitic process should be considered in cases of subacute @entity602 with persistent cellular reaction in the cerebrospinal fluid and clinical responsiveness to corticosteroid therapy. The magnetic resonance imaging scan of the spinal cord may be normal.

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@entity1 :: ('9606', 'Species') :: ['man'] @entity1690 :: ('MESH:D046628', 'Disease') :: ['sphincteric abnormalities'] @entity1333 :: ('MESH:D014657', 'Disease') :: ['Vasculitis', 'vasculitis'] @entity221 :: ('MESH:D005334', 'Disease') :: ['preterminal illness'] @entity602 :: ('MESH:D013118', 'Disease') :: ['myelopathy', 'spinal cord vasculitis'] @entity425 :: ('MESH:D018908', 'Disease') :: ['leg weakness'] @entity772 :: ('MESH:D003128', 'Disease') :: ['coma'] @entity451 :: ('MESH:C536857', 'Disease') :: ['paraplegia'] @entity346 :: ('MESH:D009759', 'Disease') :: ['nystagmus'] @entity15 :: ('MESH:D009103', 'Disease') :: ['multiple sclerosis'] @entity385 :: ('MESH:D002544', 'Disease') :: ['hemorrhagic infarction']
@entity1333 :: (MESH:D014657,Disease) :: ['Vasculitis']
