Is Intracranial Arterial Involvement A Subgroup of Neuro-Behcet Syndrome? (P5.035)

Objective: To assess the clinical and radiological patterns of cranial arterial involvement in neuro-Behcet syndrome (NBS). Background: Neurological involvement named as neuro-Behcet syndrome (NBS) occurs approximately 5-10% of Behcet Syndrome (BS) patients. In parenchymal NBS, which is more frequent, mainly brain stem lesions are seen as a result of venular inflammatory disease. Involvement of large vessels and dural sinus thrombosis are part of non-parenchymal NBS. However intra/extracranial arterial involvement in BS is extremely rare. Here we report 6 NBS patients with intracranial arterial involvement. Designs/Method: The 6 patients who were included in the study attended our NBS center between 1998-2013 and were diagnosed as NBS with cranial arterial involvement. Patients’ demographic features, risk factors, treatment protocols and prognosis were examined. Results: All patients were men. Behcet Syndrome and NBS mean age at the time of diagnosis were 25.5 ±8.1 and 29.3 ±6.0 respectively. None of the patients had hypertension, one had diabetes and one had hyperlipidemia as stroke risk factors. Four patients were smoking and 1 patient had migraine. All patients had middle cerebral artery (MCA) infarction. Magnetic resonance angiography (MRA) and echocardiography examinations were normal. Two patients were treated with azathioprine and corticosteroid, 2 patients were treated with azathihoprine and colchicine, 1 patient was taking azathioprine and 1 patient was taking colchicine during the development of brain ischemia. After ischemia, acetylsalicylic acid was added to the treatment of 3 patients and 1 patient started to take acetylsalicylic acid and dipyridamol as antiaggregant therapy. Average follow-up duration was 59.5 ±66.9 months, modified Rankin Scale scores before and after treatment were 1.3 and 0.5 respectively. Conclusion: Neurological involvement in BS patients is generally due to venous inflammation. Intracranial arterial involvement in NBS is rare, but it should be kept in mind that it can occur during the course of the disease independent of other stroke risk factors. Disclosure: Dr. Zeydan has nothing to disclose. Dr. Uygunoglu has received personal compensation for activities with Merck Serono, Biogen Idec, Novartis and Allergan Inc. as an attendee at congresses or symposia. Dr. Tutuncu has nothing to disclose. Dr. Yalcinkaya has nothing to disclose. Dr. Altintas has received personal compensation for activities with The Scientific and Technological Research Council of Turkey, Merck & Co., Inc., and Teva Neuroscience. Dr. Saipoglu has received research support from The Scientific and Technological Research Council Of Turkey, Bayer-Schering AG, and Merck Serono.