巨细胞关节炎与中枢神经系统血管炎呈现为双眼透视和死由于第三头骨神经麻
João Casanova Pinto1,2, Manuel G Costa1,3, Beatriz Fernandes1
1Internal Medicine, Hospital de Cascais Dr. José de Almeida, Alcabideche, PRT.
Cureus
|January 20, 2026
概括
巨细胞动脉炎是一种罕见的头痛和视力问题的原因,可以出现神经症状. 早期的皮质类固醇治疗对于管理这种情况和预防并发症至关重要.
科学领域:
- 神经学 神经学
- 类风湿病学 类风湿病学
- 眼科医生 眼科 眼科
背景情况:
- 巨细胞动脉炎 (GCA) 是一种系统性血管炎,影响大和中型动脉.
- GCA的神经表现可能是多样化的,但神经并不常见.
- 在GCA中,眼运动神经麻可能表明相关的中枢神经系统 (CNS) 血管炎.
研究的目的:
- 报告一种不常见的GCA神经表现,涉及第三个头骨神经.
- 突出诊断挑战和迅速治疗在GCA与非典型症状的重要性.
- 在疑似中枢神经系统血管炎的GCA病例中,将临床发现与成像和活检结果相关联.
主要方法:
- 一个60多岁的妇女的病例报告,头痛,关节,以及新发的双眼视.
- 临床检查显示了动脉和第三头骨神经麻.
- 炎症标志物的实验室测试,动脉的双重超声波,动脉活检,部CT/CTA和部MRI.
主要成果:
- 升高的炎症标志物和通过活检确认的动脉慢性炎症与GCA一致.
- 动脉双重超声波显示动脉壁变厚.
- 部MRI揭示了暗示小血管中枢神经系统血管炎的发现.
- 患者在接受皮质类固醇治疗后实现了完全临床缓解.
结论:
- 这种病例表明了GCA与眼运动神经参与的不寻常的神经表现.
- 这些发现表明,在GCA中同时存在小血管中枢神经系统血管炎.
- 早期诊断和及时的皮质类固醇治疗对于预防GCA不可逆转的并发症至关重要.
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