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Primary phlebitis of central nervous system revealed by black-blood magnetic resonance imaging
  1. Jinsoo Koh,
  2. Junko Taruya,
  3. Megumi Mori and
  4. Hidefumi Ito
  1. Department of Neurology, Wakayama Medical University, Wakayama, Japan
  1. Correspondence to Dr Jinsoo Koh; jinsoo{at}


Primary phlebitis of the central nervous system (PPCNS) is a rare condition that might be a subset of primary angiitis of the CNS. In this case report, the patient was a 39-year-old man with a 2-week history of anterograde amnesia and abnormal behaviours. Black-blood MRI (BB-MRI) showed contrast enhancement of the left basilar vein and cerebral superficial veins. Angiography showed unremarkable change in arteries. After a thorough differential diagnosis, we diagnosed PPCNS and then administered methylprednisolone pulse and cyclophosphamide pulse. The neuropsychological symptoms and MRI findings gradually improved, and after 2 months, the dose of prednisolone was gradually reduced to 20 mg. No recurrence was observed. This case shows that BB-MRI may be useful for diagnosing PPCNS.

  • neuroimaging
  • vasculitis

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  • Contributors JK, the leader of attending physicians, wrote this case report. MM and JT were the attending physicians for this patient. HI is a professor of our department and supervised the diagnosis and treatment strategy, and preparation of this case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.