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Intracranial Involvement in Takayasu's Arteritis
Andrea Johnson1, Derek Emery2, Alison Clifford1
1Division of Rheumatology, University of Alberta, Edmonton, AB T6G 2R3, Canada.
Insights
Takayasu
Area of Science:
- Neurology
- Rheumatology
- Vascular Medicine
Background:
- Takayasu's arteritis (TAK) is a large-vessel vasculitis affecting the aorta and its branches.
- Extracranial vascular involvement is common, but intracranial involvement is less understood.
Purpose of the Study:
- To determine the prevalence of intracranial vascular involvement in patients with Takayasu's arteritis.
- To describe intracranial vascular and non-vascular findings in TAK patients.
Main Methods:
- Retrospective review of clinical and imaging records of TAK patients at a Canadian university medical center.
- Analysis of neuroimaging (CTA, MRA, angiography) for intracranial vascular lesions.
- Literature review on intracranial involvement in TAK.
Main Results:
- Of 20 TAK patients, 12 underwent vascular neuroimaging.
- Intracranial vascular lesions were found in 4 patients (33.3% of those imaged, 20% of all patients).
- Findings suggest a higher prevalence of intracranial involvement than previously recognized.
Conclusions:
- Intracranial vascular involvement in Takayasu's arteritis may be more frequent than commonly believed.
- Consideration of both intracranial and extracranial vessel imaging is recommended for young TAK patients.
Abstract:
Takayasu's arteritis (TAK) is a large-vessel vasculitis that targets the aorta and its major branches. Although extracranial vascular involvement is uniformly present in this disease, the frequency of intracranial involvement in TAK has not been well studied. We retrospectively reviewed the clinical and imaging records of patients diagnosed with TAK at a single Canadian university medical centre to determine the prevalence of intracranial vascular involvement. Intracranial vascular and non-vascular findings were described, and a review of the literature was performed. Of 20 patients with TAK, 12 had vascular neuroimaging completed. Intracranial vascular lesions were identified in 4 patients (33.3% of those with imaging available, 20% of all patients). The frequency of intracranial vessel involvement in TAK may be more common than appreciated. Imaging of both the intra- and extra-cranial vessels should be considered in these young patients.
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