A case of rheumatoid meningitis with transient ischemic attack-like episodes

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  • Kutsuna Fumiya
    Department of Neurology, National Hospital Organization Nagasaki Medical Center
  • Arata Masahiko
    Residency Program, National Hospital Organization Nagasaki Medical Center
  • Ashikaga Yuya
    Department of Neurology, National Hospital Organization Nagasaki Medical Center
  • Sato Kazuaki
    Department of Neurology, National Hospital Organization Nagasaki Medical Center
  • Tokuda Masahiro
    Department of Neurology, National Hospital Organization Nagasaki Medical Center
  • Iwanaga Hiroshi
    Department of Neurology, National Hospital Organization Nagasaki Medical Center

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Other Title
  • 繰り返す一過性脳虚血発作様症状で発症したリウマチ性髄膜炎の1例

Abstract

<p>We present a case of rheumatoid meningitis with transient ischemic attack (TIA)-like episodes. A 53-year-old woman with a 3-month history of rheumatoid arthritis arrived at our hospital presenting transient right hemiparesis and aphasia. Fluid-attenuated inversion recovery and diffusion-weighted magnetic resonance imaging showed a hyperintense lesion in the frontoparietal subarachnoid space. Leptomeningeal enhancement was also revealed from gadolinium-enhanced T1-weighted images. The levels of anticyclic citrullinated peptide antibodies in the cerebrospinal fluid were elevated. Her medical history, symptoms, laboratory tests, and neuroradiological findings supported the diagnosis of rheumatoid meningitis. Her neuroradiological findings improved immediately after the commencement of corticosteroid treatment. Rheumatoid meningitis should be considered during the process of differential diagnosis of TIA mimics.</p>

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