A case of rheumatoid meningitis with transient ischemic attack-like episodes

Abstract

We present a case of rheumatoid meningitis with transient ischemic attack (TIA)-like episodes. A 53-year-old woman with a 3-month history of rheumatoid arthritis arrived at our hospital presenting transient right hemiparesis and aphasia. Fluid-attenuated inversion recovery and diffusion-weighted magnetic resonance imaging showed a hyperintense lesion in the frontoparietal subarachnoid space. Leptomeningeal enhancement was also revealed from gadolinium-enhanced T1-weighted images. The levels of anticyclic citrullinated peptide antibodies in the cerebrospinal fluid were elevated. Her medical history, symptoms, laboratory tests, and neuroradiological findings supported the diagnosis of rheumatoid meningitis. Her neuroradiological findings improved immediately after the commencement of corticosteroid treatment. Rheumatoid meningitis should be considered during the process of differential diagnosis of TIA mimics.