Intracranial GCA: a comprehensive systematic review.

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.