State of the Art Imaging in Autoimmune Cerebral Vasculitis

A common classification of cerebral vasculitis uses the size of the affected arteries and the etiology of the wall inflammation, but this classification scheme was established for systemic disease rather than cerebral disease [1,2,3,4]. Another way to classify cerebral vasculitis has been proposed by Kuker [4] dividing it into large vessel vasculitis (LVV), medium vessel vasculitis (MVV), and small vessel vasculitis (SVV). The LVV is defined as affecting the ICA, the M1 and A1 segments, the intracranial vertebral artery, basilar artery and the P1 segment. MVV affects the arteriographically demonstrable arteries distal to the M1, P1, and A1 segments. SVV affects the small arteries beyond the spatial resolution of most conventional cerebral angiography. Some etiologies of vasculitis affect a combination of different sized vessels. In this presentation, we will focus on autoimmune vasculitis, for example, systemic lupus erythematosis (SLE), Sjogrens, and rheumatoid arthritis, which mainly affect small vessels.