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Related Experiment Videos

Systemic giant cell arteritis and cerebellar infarction

C A Mclean1, M F Gonzales, J P Dowling

  • 1Department of Anatomical Pathology, Royal Melbourne Hospital, Victoria, Australia.

Stroke
|June 1, 1993
PubMed
Summary

Systemic giant cell arteritis can rarely cause cerebellar infarction by affecting the anterior inferior cerebellar artery. This case highlights an infrequent but serious neurological complication of this systemic vasculitis.

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Area of Science:

  • Neurology
  • Vascular Neurology
  • Rheumatology

Background:

  • Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting medium and large arteries.
  • Intracranial involvement of GCA, though uncommon, can lead to severe neurological deficits.
  • Cerebellar infarction due to intracranial GCA, particularly involving the anterior inferior cerebellar artery (AICA), is exceptionally rare.

Observation:

  • An 85-year-old woman presented with episodic ataxia, unilateral headaches, and vomiting.
  • Clinical examination revealed cerebellar signs and a cardiac murmur.
  • Postmortem examination confirmed cerebellar infarction secondary to arteritis of the AICA and basilar arteries, with evidence of systemic GCA.

Findings:

  • This case represents the first reported instance of cerebellar infarction caused by GCA affecting the AICA.

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  • The pathological findings demonstrated GCA involvement of intracranial arteries, leading to ischemic stroke in the cerebellum.
  • Systemic GCA was confirmed, indicating a widespread inflammatory process.

    • Implications:

    • Giant cell arteritis should be considered in the differential diagnosis of cerebellar infarction, especially in elderly patients with compatible symptoms.
    • The pattern of intracranial vessel involvement in GCA can be distinct from isolated cranial angiitis.
    • Understanding these rare presentations is crucial for accurate diagnosis and management of GCA complications.