Granulomatous Angiitis of the Central Nervous System

AMONG the noninfective inflammatory diseases of the blood vessels is a rare form of granulomatous angiitis that is almost entirely confined to the central nervous system (CNS). The lesions, which are focal and often necrotizing, are generally associated with multinucleate giant cells. Before its delineation as a distinct clinicopathologic entity by Cravioto and Feigin,¹the condition was variously designated as "Morbus Boeck" (Zollinger²), "allergic angiitis and allergic granulomatosis" (Churg and Strauss,³Newman and Wolf⁴) and "giantcell arteritis" (McCormick and Neubuerger⁵). To our knowledge, 14 cases of the disorder have been reported up to now,¹,²,⁴⁻¹¹of which two appeared in the form of clinicopathologic discussions in the Cabot case series from the Massachusetts General Hospital.⁶,⁷These two cases, and two additional ones more recently studied at this hospital, are the subject of the present communication. Serial sections of typical lesions from one of the