Partial Seizures as the First Manifestation of Primary Angiitis of the Central Nervous System

A young woman presented with initial epileptic seizures and multiple ‘mass-like’ lesions seen on computed tomography and magnetic resonance imaging. Given this presentation and her past medical history, a cerebral biopsy was performed to rule out malignancy, but showed a necrotizing cerebral vasculitis. We describe this case to reinforce the view that primary central nervous system vasculitis (PCNSV) should be considered in the differential diagnosis of a cerebral mass, even if uncommon. LEARNING POINTS: PCNSV may cause a variety of clinical manifestations including seizures. PCNSV lesions can mimic a cerebral mass. Brain biopsy remains the gold standard for the diagnosis of PCNSV, especially to rule out a cancer diagnosis.