Multiple bilateral non-hemorrhagic cerebral infarctions associated with microscopic polyangiitis

Microscopic polyangiitis (MPA) is a systemic disorder that affects small vessels, such as arterioles, venules or capillaries. Cerebrovascular disease has been rarely reported in connection with MPA; this complication is usually associated with fatal hemorrhage or hemorrhagic conversion. We report a case of MPA with multiple bilateral non-hemorrhagic cerebral infarctions in a 66-year-old woman who was undergoing steroid pulse therapy. The diagnosis of MPA was based on the presence of painful mononeuritis multiplex, pulmonary fibrosis, and increased myeloperoxidase activity and on the biopsy of the sural nerve. (C) 2009 Elsevier B.V. All rights reserved.