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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 24:523-525, March 2003
© 2003 American Society of Neuroradiology

BRAIN

Wegener Granuloma in the Fourth Ventricle

Ansgar Berlis^a, Franziska Petschner^b, Ingolf Carl Bötefür^c and Joachim Spreer^a

^a Department of Neuroradiology, University of Freiburg, Freiburg, Germany
^b Department of Rheumatology and Clinical Immunology, University of Freiburg, Freiburg, Germany
^c Department of Neuropathology, University of Freiburg, Freiburg, Germany

Address reprint requests to Dr. Ansgar Berlis, Department of Neuroradiology, University of Freiburg, Breisacherstr. 64, D-79106, Freiburg, Germany

Summary: We report the case of a 57-year-old man with a known history of antineutrophil cytoplasmic antibody-positive Wegener granulomatosis with initial involvement of the upper and lower respiratory tract. MR imaging of the brain was performed because of new onset CNS symptoms (nausea, altered mental status). The images revealed a mass in the fourth ventricle. The mass diminished in size after systemic steroid treatment, as shown by follow-up MR imaging. The patient died in acute respiratory distress secondary to pneumonia. Histopathologic findings confirmed a Wegener granuloma of the fourth ventricle.