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Related Experiment Video

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Intracranial GCA: a comprehensive systematic review.

Sagar Patel1, Iva Okaj1, Jessica Scott1

  • 1Division of Rheumatology, Department of Medicine, McMaster University, Hamilton, ON, Canada.

Rheumatology (Oxford, England)
|March 25, 2025
PubMed
Summary

Intracranial giant cell arteritis (ICGCA) is a significant condition, often presenting as stroke. This systematic review highlights ICGCA as a potentially severe GCA manifestation requiring further study for optimal treatment strategies.

Keywords:
GCAbraindiagnostic imagingsystematic reviewvasculitis

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Area of Science:

  • Neurology
  • Rheumatology
  • Vascular Medicine

Background:

  • Giant cell arteritis (GCA) is an autoimmune vasculitis.
  • Intracranial involvement in GCA (ICGCA) is increasingly recognized but poorly understood.
  • Clinical ramifications of ICGCA are largely unknown.

Purpose of the Study:

  • To systematically review and describe the clinical presentations, investigations, treatments, and outcomes of intracranial GCA.
  • To determine the prevalence and characteristics of ICGCA based on existing literature.

Main Methods:

  • Systematic literature review of MEDLINE, Embase, and Pubmed databases.
  • Inclusion criteria: studies reporting histopathologically or imaging-confirmed ICGCA.
  • Data synthesis using descriptive statistics.

Main Results:

  • 340 patients with ICGCA identified from 102 studies.
  • Stroke was the most common presentation (70.6%).
  • Vertebrobasilar (52.9%) and internal carotid (48.8%) arteries were most frequently involved; relapse occurred in 22.1%, mortality in 32.6%.

Conclusions:

  • ICGCA is not rare and may indicate a more severe form of GCA.
  • Current optimal therapy for ICGCA remains undetermined.
  • Prospective studies are essential for better understanding and management of ICGCA.