Primary central nervous system vasculitis disguised as tumor-like granulomatous angiitis and multifocal subdural hematomas: A case report and literature review

Primary central nervous system vasculitis (PCNSV) is a rare inflammatory disorder limited to the brain and/or spinal cord that destroys CNS vessels without evidence of vasculitis outside the CNS. We present a case of a 52-year-old male who complained of a tension headache and dizziness. He was diagnosed postbiopsy with PCNSV that was initially disguised by a tumor-like lesion and multifocal subdural hematomas seen on MRI. Our report highlights the value of considering PCNSV as a differential diagnosis in patients with subdural hemorrhage that has never been previously recognized and emphasizes the value of a brain biopsy for confirming the diagnosis. Our report also shows the efficacy of steroid and immunosuppressive therapy in treating PCNSV.