Yosuke Nakayama1, Yoshinobu Kamio2, Naoki Kato1, Yuichi Murayama1. 1. Department of Neurosurgery, Jikei University School of Medicine, Minato-Ku, Tokyo, Japan. 2. Department of Neurosurgery, Jikei University School of Medicine, Minato-Ku, Tokyo, Japan. Electronic address: kyoshi429520@gmail.com.
Abstract
BACKGROUND: Cerebral vasculitis owing to chronic graft-versus-host disease (GVHD) is very rare. To our knowledge, only 2 cases have been reported. We describe the first case of superficial temporal artery-middle cerebral artery (STA-MCA) bypass for cerebral vasculitis owing to GVHD. CASE DESCRIPTION: A 59-year-old woman presented with right upper extremity weakness and dysarthria 33 months after undergoing matching allogenic bone marrow transplantation. The patient had STA-MCA bypass for MCA occlusion and resting cerebral blood flow in the left MCA area improved. CONCLUSIONS: Although the mechanism of cerebral vasculitis after chronic GVHD is not known, cerebral vasculitis that causes cerebrovascular disease long after bone marrow transplantation should be considered. In this case, an STA-MCA bypass was efficient for the repeated ischemic attacks owing to cerebral vasculitis. Moreover, it is important to select the optimal recipient vessels to area originated neurologic symptoms.
BACKGROUND:Cerebral vasculitis owing to chronic graft-versus-host disease (GVHD) is very rare. To our knowledge, only 2 cases have been reported. We describe the first case of superficial temporal artery-middle cerebral artery (STA-MCA) bypass for cerebral vasculitis owing to GVHD. CASE DESCRIPTION: A 59-year-old woman presented with right upper extremity weakness and dysarthria 33 months after undergoing matching allogenic bone marrow transplantation. The patient had STA-MCA bypass for MCA occlusion and resting cerebral blood flow in the left MCA area improved. CONCLUSIONS: Although the mechanism of cerebral vasculitis after chronic GVHD is not known, cerebral vasculitis that causes cerebrovascular disease long after bone marrow transplantation should be considered. In this case, an STA-MCA bypass was efficient for the repeated ischemic attacks owing to cerebral vasculitis. Moreover, it is important to select the optimal recipient vessels to area originated neurologic symptoms.
Authors: Geoffrey D E Cuvelier; Michelle Schoettler; Nataliya P Buxbaum; Iago Pinal-Fernandez; Marc Schmalzing; Jörg H W Distler; Olaf Penack; Bianca D Santomasso; Robert Zeiser; Klemens Angstwurm; Kelli P A MacDonald; W Taylor Kimberly; Naomi Taylor; Ervina Bilic; Bernhard Banas; Maike Buettner-Herold; Namita Sinha; Hildegard T Greinix; Joseph Pidala; Kirk R Schultz; Kirsten M Williams; Yoshihiro Inamoto; Corey Cutler; Linda M Griffith; Stephanie J Lee; Stefanie Sarantopoulos; Steven Z Pavletic; Daniel Wolff Journal: Transplant Cell Ther Date: 2022-05-31