The Brain and Vasculitis

Welcome and Introductions

VF Webinar Host, Kathy Olevsky, introduces Dr. Shubhasree Banerjee, MD, an Assistant Professor of Clinical Medicine at the University of Pennsylvania and a member of the Penn Vasculitis Center.

The Brain and Vasculitis Presentation

Single organ vasculitis.	2:37
Brain ischemia and hemorrhage.	8:06
Inflammation of the brain and meninges.	8:48
Cranial nerve involvement.	9:48
Symptoms of brain involvement.	10:48
Diagnosis of vasculitis of the brain.	11:40
Investigations.	12:20
Common mimics of brain vasculitis.	14:17
Medication side effects.	14:53
Side effects from prednisone.	15:25
Strategies to minimize medication induced side effects.	16:04
Metabolic derangements.	16:43
Infections.	17:49
Investigations.	18:48
How to address the symptoms concerning brain involvement.	19:53
Primary CNS Vasculitis.	21:08
CNS manifestations.	21:34
CNS diagnosis.	22:04
The CNS-Vasculitis Longitudinal Study	23:03
Take home points.	23:39

Dr. Banerjee will shares what you need to know about how systemic vasculitis can impact the brain (including cranial nerve involvement, brain ischemia and hemorrhage, and meningitis/encephalitis). She also discusses diagnosis and treatment strategies, mimics of brain vasculitis, and primary central nervous system (CNS) vasculitis, a very rare form of vasculitis.

Q&A for the Brain and Vasculitis Webinar

Q: Is there a link between vertigo and vasculitis?	0:31
Q: How would you define CNS vasculitis?	2:22
Q: Is chronic lack of sleep related to brain vasculitis?	4:10
Q: Is fatigue and cognitive confusion caused by the disease, or the medication?	5:54
Q: Can you talk about cognitive issues with ANCA vasculitis? Is it true that small vessels don’t really show on an MRI so it’s harder to diagnosis.	6:51
Q: How does a PET scan differ from MRI with imaging of the small blood vessels?	8:33
Q: Can COVID cause many of the symptoms related to vasculitis with the brain?	9:33
Q: How can Behcet’s vasculitis affect the brain?	11:01
Q: I have nerve damage from EGPA. Or is brain vasculitis a separate disease?	12:07
Q: Does normal shrinkage of the brain in the elderly impact vasculitis?	12:57
Q: Do you have experience treating psychiatric symptoms like auditory hallucinations with CNS vasculitis?	14:16
Q: Can menopausal issues mimic vasculitis involvement with the brain?	15:53
Q: How long do you typically keep a patient with CNS on immunosuppressant medication?	16:40
Q: Is there any evidence of the COVID vaccine and the onset of CNS vasculitis?	17:13
Q: I’m having issues with clear thinking ever since being diagnosed with CNS vasculitis. Is this uncommon?	18:23
Q: Does the brain deteriorate in most cases of Giant Cell Arteritis?	20:36
Q: How do I find a neurologist specializing in vasculitis?	21:24
Q: Can vasculitis lead to behavior problems like restlessness?	21:55
Q: How can I get involved with the CNS Longitudinal Study?	25:00

Q&A Part 2: The Brain and Vasculitis

Dr. Marinka Twilt
Recorded 11/1/23

What are the signs of CNS vasculitis on an MRI? Are MRI findings always definitive with regards to diagnosis of CNS	1:12
Could you give some detail about gadolinium. I’ve researched online and read some alarming things such as the contrast being toxic. Are there any preventive strategies prior to the MRI scan and using gadolinium to offset a potential reaction?	4:12
If someone with GCA has persistent cognitive symptoms on high-dose prednisone (with normalization of crp and esr), should they have scans/monitoring of vascular anatomy?	6:40
I have had brain scans since childhood but only a Chiari malformation showed as my vasculitis became systemic. I have heard this from others as well – have you seen this?	9:38
What research has been done regarding seizures in vasculitis patients? I am currently taking Imuran to limit inflammation and 2 anticonvulsants for CNS vasculitis-related seizures, yet I still have occasional breakthrough seizures.	11:34
What are 2-3 of the question you want patients, or caregivers to ask you when they have brain involvement with vasculitis?	13:57

In this recorded webinar, Dr. Marinka Twilt answers some of the questions that were not included in the original webinar with Dr. Banerjee.

Click here to see a PDF of the slides for this webinar.

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