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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 23:221-224, February 2002
© 2002 American Society of Neuroradiology

Case Report
BRAIN

Intracranial Meningeal Involvement in Churg-Strauss Syndrome

Aya M. Tokumaru^a, Tatsuo Obata^b, Shinya Kohyama^a, Tatsumi Kaji^a, Hiromi Okizuka^a, Kimihiro Suzuki^b and Shoichi Kusano^a

^a Department of Radiology, National Defense Medical College, Saitama, Japan
^b Department of Internal Medicine, National Defense Medical College, Saitama, Japan

Address reprint requests to Aya M. Tokumaru, MD, Department of Radiology, National Defense Medical Collgee, 3–2 Namiki-Cho, Tokorozawa City, Saitama Japan 359-8513

Summary: We describe the case of a 54-year-old woman with a clinical diagnosis of Churg-Strauss syndrome (CSS). The patient had a fever of unknown origin, severe headache, progressing left ophthalmoplegia, and visual acuity disturbance. MR imaging revealed diffuse and thick hypointense lesions on T2-weighted images in the frontal meninges and anterior falx cerebri with diffuse enhancement. Similar lesions were also detected in the left superior ophthalmic fissure to the cavernous sinus. Nodular lesions in the fourth ventricle, which might have been the cause of hydrocephalus, were hypointense on T2-weighted images. These MR imaging findings suggested remote granulomatous involvement in the meninges and choroid plexus associated with CSS. To our knowledge, remote meningeal involvement in association with CSS has not been previously reported.