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Multifocal dural enhancement associated with temporal arteritis
E Joelson1, B Ruthrauff, F Ali
1Department of Neurology, University of California, San Francisco, USA.
Objective:
To report the association of temporal arteritis and enhancement of the dura mater and temporalis muscle.
Design And Methods:
A single patient with a complaint of headache and diplopia was studied.
Setting:
Academic medical center.
Patient:
A 69-year-old man presented with lateral rectus weakness, temporal artery tenderness, and an erythrocyte sedimentation rate of 65 mm/h.
Intervention:
Biopsy of temporal artery and dura mater.
Main Outcome Measures:
Brain magnetic resonance imaging and pathological findings.
Results:
Magnetic resonance imaging of the brain showed multifocal dural enhancement and enhancement of the temporalis muscles. The temporal artery showed a necrotizing vasculitis and the dura showed perivascular inflammatory cells.
Conclusion:
It is proposed that the temporal arteritis caused the multifocal dural enhancement and temporalis muscle enhancement on magnetic resonance imaging.
Insights
Temporal arteritis, a form of vasculitis, can cause inflammation in the dura mater and temporalis muscles. This case report highlights the association observed via magnetic resonance imaging (MRI) and biopsy.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Giant cell arteritis (GCA) typically affects large and medium arteries.
- Cranial involvement in GCA can manifest in various ways, including neurological symptoms.
Observation:
- A 69-year-old male presented with headache, diplopia, and temporal artery tenderness.
- Elevated erythrocyte sedimentation rate (ESR) suggested an inflammatory process.
Findings:
- Brain MRI revealed multifocal dural and temporalis muscle enhancement.
- Temporal artery biopsy confirmed necrotizing vasculitis.
- Dural biopsy showed perivascular inflammatory infiltrates.
Implications:
- This case suggests a potential link between temporal arteritis and dural/temporalis muscle enhancement on MRI.
- Further research may elucidate the mechanisms and diagnostic significance of these imaging findings in GCA.