Article Figures & Data
Figures
- Fig 1.
Brain biopsies from different patients showing typical sarcoid granuloma (short arrows) with a Langerhans-type giant cell (long arrow) (H&E, original magnification ×20) (A), transmural granulomatous involvement of a meningeal vessel (short arrows, star represents the residual vessel lumen) (H&E, original magnification ×20) (B), and granulomatous vessel wall involvement (long arrows) with fibrinoid necrosis (short arrows) (H&E, original magnification ×10) (C).
- Fig 2.
Axial DWIs at the level of the corona radiata obtained at 2 different time points (A and B) show recurrent periventricular infarcts. Axial magnified pre- (C) and postcontrast (D) images reveal subtle perivascular enhancement involving the bilateral basal ganglia (arrowheads, D).
- Fig 3.
Axial DWIs reveal tiny subcortical infarcts (A and B) in a 22-year-old female patient. Axial postcontrast image (C) shows prominent involvement of the midline falx anteriorly. The infarcts were presumably secondary to involvement of the cortical vessels.
- Fig 4.
Axial DWI (A) in a 38-year-old male patient with NS reveals punctate infarcts involving the left cerebral peduncle and midbrain (arrows). A volume-rendered CT angiogram shows multifocal stenoses involving the P1 segments of the bilateral posterior cerebral arteries (B). The patient again presented after 2 months with severe headache. Noncontrast CT (C) image at this time shows acute subarachnoid hemorrhage over bilateral parietal convexities (arrows).
- Fig 5.
Axial SWI at the level of centrum semiovale (A) and basal ganglia (B) from 1 patient and at the level of basal ganglia in the other patient (C). There are multiple scattered foci of susceptibility involving bilateral subcortical white matter (arrows) with relative sparing of the basal ganglia in both patients.
- Fig 6.
A and B, Axial postcontrast images through the posterior fossa obtained over an interval of 10 years. The prominent left sigmoid sinus enhancement remains essentially unchanged. The patient also had superior sagittal sinus involvement (not shown).
- Fig 7.
Coronal pre- (A) and postcontrast (B) images in a patient with NS show nodular thickening and enhancement of the cavernous sinuses bilaterally. The patient had additional intracranial stigmata of NS (not shown), and the cavernous sinus involvement was presumed to be secondary to NS.
Tables
Author Year Age (yr)/Sex Zajicek Criteria CT/MRI DWI TIA Stroke Systemic Disease Brown et al12 1989 25/M Probable Y/NS NS Y Left IC and corona radiata Y Corse and Stern26 1990 38/M Probable Y/Y NS Y Right IC Y Michotte et al4 1991 29/M Probable Y/Y NS N Left BG, right frontal Y Zadra et al24 1996 30/M Probable Y/Y NS N Multiple, anterior circulation Y Das et al30 1998 27/F Probable Y/NS NS N Left MCA infarct Y Brisman et al3 2006 41/M Probable NS/Y Y N Multiple, anterior circulation Y Hodge et al2 2007 36/F Definite NS/Y Y N Left BG N Navi and DeAngelis31 2009 35/M Definite NS/Y N N Pons Y Navi and DeAngelis31 2009 46/F Definite Y/Y NS N Pons Y González-Aramburu et al15 2012 27/M Probable Y/Y Y Y Right IC and thalamus Y Campbell et al32 2015 26/M Probable Y/Y Y Y Left centrum semiovale Y Raza and Schreck25 2017 73/F Probable NS/Y NS N Recurrent left MCA strokes Y Macedo et al5 2016 62/M Possible Y/Y Y Y Multiple, anterior/posterior circulation Y Note:—BG indicates basal ganglia; IC, internal capsule; N, no; NS, not specified; Y, yes.
↵a On the basis of the Zajicek criteria,1 cases may be definite (neural tissue biopsy), probable (presence of CNS inflammation with evidence of systemic disease), or possible (clinical presentation consistent with NS with exclusion of alternate diagnosis).
Author Year Age (yr)/Sex Zajicek Criteria CT/MRI MRA/DSA Site Systemic Disease Caplan et al28 1983 21/M Probable Y/NS NS Left cerebellar Y Oksanen46 1986 NS/NS NS NS/NS NS NS NS Oksanen46 1986 NS/NS NS NS/NS NS NS NS Berek et al40 1993 35/M Possible Y/Y Nm DSA SAH on LP N Libman et al42 1997 48/F Probable Y/Y + DSA Multiple, left cerebral hemisphere Y Eid et al43 1998 31/F Probable Y/NS + DSA Right frontal Y Cipri et al47 2000 31/M Definite Y/Y Nm DSA Right occipital N Dakdouki et al45 2005 25/M Probable NS/Y NS Pons Y Tsappidi et al38 2011 43/M Definite Y/Y Nm DSA/MRA Multiple, supratentorial N O'Dwyer et al36 2013 41/M Definite Y/Y Nm CTA Cerebellum N O'Dwyer et al36 2013 41/M Probable Y/Y Nm MRA Pontomesecephalic Y O'Dwyer et al36 2013 36/M Probable Y/Y Nm DSA Left frontal Y Travers et al44 2014 37/M Probable NS/Y Nm Right temporal Y Pegat et al41 2015 48/F Probable NS/Y NS Left frontoparietal Y Vargas et al37 2016 62/F Probable Y/Y Nm MRA Multiple microhemorrhages Y Vukojević et al39 2017 45/F Probable Y/Y Nm CTA Multiple, supra- and infratentorial Y Note:—Nm indicates normal findings; LP, lumbar puncture; N, no; NS, not specified; Y, yes; +, positive.
Jump to section
Related Articles
Cited By...
- Neurosarcoidosis: Pathophysiology, Diagnosis, and Treatment
- Vascular Involvement in Neurosarcoidosis: Early Experiences From Intracranial Vessel Wall Imaging
- Neurosarcoidosis presenting with a partial Claude syndrome
- Engorged Medullary Veins in Neurosarcoidosis: A Reflection of Underlying Phlebitis?
- Engorgement of Deep Medullary Veins in Neurosarcoidosis: A Common-Yet-Underrecognized Cerebrovascular Finding on SWI