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Primary angiitis of the central nervous system (PACNS) remains one of the most challenging forms of vasculitis. Its diagnosis requires the presence of an acquired neurological deficit, classic angiographic evidence consistent with vasculitis or histopathological demonstration of angiitis within the central nervous system (CNS), and no evidence of systemic vasculitis or another autoimmune, infectious or malignant process.1 Antiphospholipid syndrome (APS) involves recurrent arterial or venous thrombosis, pregnancy loss, and repeated detection of anticardiolipin antibodies or lupus anticoagulant at least 6 weeks apart.2 APS may result in neurological complications such as stroke, migraine, chorea, seizures or transverse myelitis. There has been no reported association between APS and PACNS. We present the first two cases of PACNS and simultaneous APS.
Patient 1 is a 76 year old man presenting with headaches, mental status changes progressing to somnolence, and neurological …
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