Intracranial rheumatoid nodule causing recurrent transient neurological deficits. Issue 1 (5th October 2022)

• Record Type: Journal Article
• Authors: Brossard-Barbosa, Natalie; Donaldson, Laura; Sokolova, Elena; AlShafai, Laila; Margolin, Edward
• Is Part Of: Practical neurology. Volume 23:Issue 1(2023)
• Page Start: 78
• Page End: 81
• Publication Date: 2022-10-05
• Subjects: neuropathology -- neuroophthalmology -- rheumatology; Neurology -- Periodicals; 616.8005
• DOI: 10.1136/pn-2022-003489
• Languages: English
• ISSNs: 1474-7758

Abstract

Abstract : A 67-year-old man with rheumatoid arthritis developed recurrent acute onset of stereotyped focal neurological abnormalities. Cerebral imaging showed a mass lesion in the left parieto-occipital lobe. Imaging did not show the time evolution expected in stroke and so he underwent an extensive workup, which was inconclusive. Brain biopsy identified a rheumatoid nodule causing an extensive inflammatory reaction that mimicked a mass. Following treatment with intravenous corticosteroids and rituximab infusions, his clinical condition improved. While rheumatoid meningitis is well recognised, a rheumatoid nodule in the brain rarely presents as a mass lesion. Nevertheless, it is important to consider rheumatoid nodule in the differential diagnosis of a cerebral mass lesion in patients with rheumatoid arthritis.