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Updated: Aug 10, 2026
08:22
Isolation and Flow Cytometric Assessment of Neuroimmune Interactions in a Mini-Stroke Murine Model
Published on: June 20, 2025
Recurrent ischemic strokes with normal inflammatory markers: when tests mislead
Isabel Ros González1, Daniel Pérez Gil2, Leticia Martín Gil2
1Neurology Department, Hospital Infanta Elena, Valdemoro, Madrid, Spain. isabelros95@hotmail.com.
Acta Neurologica Belgica
|August 8, 2026
Summary
Giant cell arteritis (GCA) can cause ischemic stroke, even with normal inflammatory markers. Diagnosis and treatment for this aggressive intracranial GCA relied on clinical and imaging findings.
Area of Science:
- Neurology
- Rheumatology
- Vascular Medicine
Background:
- Giant cell arteritis (GCA) is a rare cause of ischemic stroke.
- Diagnosis is difficult when inflammatory markers are normal.
- Intracranial involvement presents unique challenges.
Purpose of the Study:
- To describe a case of recurrent ischemic strokes due to GCA.
- To highlight diagnostic challenges in GCA without elevated inflammatory markers.
- To illustrate treatment strategies for aggressive intracranial GCA.
Main Methods:
- Case report of a 67-year-old woman with recurrent ischemic strokes.
- Neuroimaging revealed bilateral internal carotid artery stenosis.
- Temporal artery ultrasound and biopsy confirmed GCA.
- Treatment involved glucocorticoids, tocilizumab, and cyclophosphamide.
Main Results:
- The patient experienced recurrent ischemic strokes despite initial therapy.
- Diagnosis was confirmed via imaging and biopsy.
- Cyclophosphamide achieved disease stabilization.
- Clinical and imaging findings were crucial for diagnosis.
Conclusions:
- Aggressive intracranial GCA can occur with normal inflammatory markers.
- Diagnosis requires a combination of clinical suspicion, imaging, and biopsy.
- Multidrug therapy may be necessary for refractory cases.
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