RT Journal Article
SR Electronic
T1 Rheumatoid meningitis can present MRI findings that mimic chronic subdural haematoma
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e229642
DO 10.1136/bcr-2019-229642
VO 12
IS 8
A1 Kaoru Yagita
A1 Akiyo Shinde
A1 Toshihiko Suenaga
YR 2019
UL http://casereports.bmj.com/content/12/8/e229642.abstract
AB A 65-year-old woman with long-standing rheumatoid arthritis (RA) experienced a recurrent tingling sensation in her left arm followed by aphasia and a tingling sensation in her right arm. A subsequent imaging study showed bilateral subdural fluid accumulation and we initially diagnosed her with a transient ischaemic attack and chronic subdural haematoma (CSDH). The cerebral spinal fluid study revealed an inflammatory response without any indications of infection or malignant tumours. After a meningeal biopsy, we redefined the diagnosis to rheumatoid meningitis (RM), and the patient showed remarkable improvement with prednisolone administration. RM should be considered as an alternative diagnosis when examining central nervous system diseases in patients with RA, as RM presents a highly variable clinical picture with image findings similar to those of CSDH.