ABSTRACT
Rheumatoid meningitis (RM) is one of the most severe complications of rheumatoid arthritis. The mortality rate of RM is relatively high and diagnosis can be difficult. We present an 80-year-old woman who was diagnosed with microscopic findings of RM after analysis of biopsy specimens taken from a brain lesion. MRI scanning revealed meningeal enhancement in the brain, and the pathological findings were those of meningeal lymphocytic infiltration, vasculitis and rheumatoid nodules. RM is a treatable disease and in this patient RM was diagnosed on the basis of biopsy findings.
Subject(s)
Arthritis, Rheumatoid/complications , Brain/pathology , Meninges/pathology , Meningitis, Aseptic/immunology , Meningitis, Aseptic/pathology , Aged, 80 and over , Arachnoid/pathology , Arachnoid/surgery , Biopsy , Brain/surgery , Diagnosis, Differential , Dura Mater/pathology , Dura Mater/surgery , Female , Humans , Lymphocyte Activation , Magnetic Resonance Imaging , Meninges/immunology , Meninges/surgery , Meningitis, Aseptic/physiopathology , Rheumatoid Nodule/etiology , Rheumatoid Nodule/pathology , Rheumatoid Nodule/physiopathology , Steroids/pharmacology , Steroids/therapeutic use , Treatment Outcome , Vasculitis/etiology , Vasculitis/pathologyABSTRACT
Patients with cerebellar infarction frequently make an excellent functional recovery. However, the mechanisms of functional recovery from cerebellar infarction remain unclear. Thus, functional MRI was used to investigate these mechanisms in six right-handed patients with complete recovery after cerebellar infarction, and nine right-handed normal subjects. The non-infarcted side of the cerebellum and the sensorimotor cortex contralateral to the non-infarcted side of the cerebellum were significantly activated during the infarcted-side hand movement. In the infarcted side of the cerebellum, intact regions were activated. Our results indicate that recovery from cerebellar infarction depends on reorganization in the infarcted side of the cerebellum, and recruitment of the cerebellocortical loop involving the cerebrum ipsilateral to the movement and the cerebellum contralateral to the movement.
