A giant cause of stroke.
K K Y Kong1, A D Mackinnon2, L R Bridges3
1Acute and Stroke Medicine Specialty Registrar, Atkinson Morley Regional Neuroscience Centre, St Georges Hospital, Blackshaw Road, Tooting, London.
Acute Medicine
|June 19, 2014
Summary
Giant cell arteritis (GCA) can cause stroke by affecting arteries supplying the brain. Early diagnosis and steroid treatment, like prednisolone, led to a patient's recovery from confusion and neurological deficits.
Area of Science:
- Neurology
- Rheumatology
- Vascular Medicine
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting large and medium-sized arteries.
- Posterior circulation infarcts can present with non-specific neurological symptoms, complicating diagnosis.
Observation:
- An 80-year-old male presented with subacute onset of drowsiness and confusion.
- Cerebral MRI revealed multiple infarcts in the posterior circulation.
- Elevated erythrocyte sedimentation rate (ESR) and multifocal stenosis in vertebral arteries raised suspicion for extracranial vasculitis.
Findings:
- Temporal artery biopsy confirmed chronic granulomatous inflammation, characteristic of giant cell arteritis (GCA).
- The patient experienced significant neurological recovery after initiating prednisolone treatment.
Implications:
- This case highlights the importance of considering GCA in elderly patients with posterior circulation strokes and elevated inflammatory markers.
- Prompt diagnosis and immunosuppressive therapy are crucial for favorable outcomes in GCA-induced cerebrovascular events.
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