Cerebrale vasculitis, een diagnostisch doolhof

• A diagnosis of cerebral vasculitis is frequently considered in patients with new or progressive neurological symptoms for which there is no other explanation.
• A clinician considering a diagnosis of cerebral vasculitis should be well aware of alternative diagnoses, since these are generally more common.
• Several consecutive examinations are required for diagnosing cerebral vasculitis, because there is no diagnostic procedure that is highly sensitive as well as highly specific.
• The added value of the different procedures may depend on the type of blood vessels involved.
• Standard MRI examinations are sensitive but not specific.
• Special MRI techniques now make it also possible to make images of the vessel wall itself.
• Catheter angiography remains important, especially when non-invasive angiographic techniques do not reveal any abnormalities.
• Brain biopsy can provide proof of cerebral vasculitis and also serves to exclude mimicking conditions.

Conflict of interest and financial support: ICMJE forms provided by the authors are available online along with the full text of this article.