Stroke as the initial presentation of Takayasu's arteritis: A case report

In this study, we report the case of a pediatric neurology stroke patient who was ultimately diagnosed with Takayasu's Arteritis. Our case describes a 14-year-old Hispanic female with no significant past medical history who presented to an outside hospital for acute onset of confusion and right sided weakness. She was given tissue plasminogen activator (TPA) at the outside hospital and transferred as a stroke alert. Initial The NIH stroke scale (NIHSS) was 12 with primarily right sided symptoms. Physical exam was also significant for asymmetric pulses and blood pressures. Imaging was significant for multifocal stenosis. She was ultimately diagnosed with Takayasu's arteritis and treated with a multidisciplinary approach including pediatrics, neurology and rheumatology. This case represents an important differential diagnosis for pediatric stroke patients including those who have stroke as the presenting symptom of this systemic disease.