Neurosurgical Manifestations of Rheumatologic Diseases: Clinical, Imaging, and Surgical Implications.

This article reviews the neurosurgical considerations and clinical manifestations of giant cell arteritis, rheumatoid arthritis-related cervical spine disease, ankylosing spondylitis, systemic lupus erythematosus, neurosarcoidosis, and Lyme disease. Across these disease entities, neurosurgical urgency typically reflects inflammatory vascular compromise, skeletal instability, occult fracture with secondary neurologic deficits, or mass-like and meningeal phenotypes that mimic malignancy or infection. The article emphasizes pattern-based triage, high-yield imaging selection, and the limited scenarios requiring neurosurgical intervention including stabilization, CSF diversion, decompression, or biopsy.