scholarly journals Isolated Bilateral Internal Carotid Artery Stenosis and Recurrent Ischemic Strokes in a Patient with Suspected Giant Cell Arteritis

2020 ◽  
Vol 12 (1) ◽  
pp. 84-91
Author(s):  
Clemens Oerding ◽  
Ingmar Kaden ◽  
Kai Wohlfarth
Keyword(s):  
Ischemic Stroke ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Carotid Arteries ◽  
Bypass Surgery ◽  
Internal Carotid ◽  
Internal Carotid Artery Stenosis ◽  
Common Type ◽  
Hemodynamic Impairment ◽  
Internal Carotid Arteries

Giant cell arteritis (GCA) is a common type of vasculitis and may present various forms. Ischemic stroke is one of the complications and sometimes the first symptom of this disease. We want to present the case of a 58-year-old female patient with suspected GCA who suffered from recurrent ischemic strokes due to progressive stenosis of the internal carotid arteries. This site of manifestation is rare but indicative of GCA. The patient was first treated with corticosteroids and methotrexate later with tocilizumab. Facing progressive hemodynamic impairment, an extra-intracranial-bypass-surgery was performed. Although inflammatory activity was reduced, new strokes occurred.

Bilateral Carotid Siphon Involvement in Giant Cell Arteritis

Neurosurgery ◽  
1986 ◽  
Vol 18 (6) ◽  
pp. 773-776 ◽  
Author(s):  
Frederick M. Vincent ◽  
Tish Vincent
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
High Dose ◽  
Ischemic Optic Neuropathy ◽  
Vascular Changes ◽  
Bilateral Carotid ◽  
Internal Carotid Arteries ◽  
Bilateral Carotid Artery

Abstract A 60-year-old woman with inadequately treated giant cell arteritis developed an acute unilateral ischemic optic neuropathy associated with bilateral carotid artery and orbital bruits. Angiography demonstrated vascular changes compatible with arteritis localized to the cavernous and petrous segments of both internal carotid arteries. After treatment with high dose steroids, the bruits disappeared.

Giant Cell (Temporal) Arteritis Involving Both External and Internal Carotid Arteries

1999 ◽  
Vol 26 (7) ◽  
pp. 469-473
Author(s):  
Mikimasa Noguchi ◽  
Takashi Tatezawa ◽  
Shigeyuki Nakajima ◽  
Osamu Ishikawa
Keyword(s):  
Giant Cell ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Temporal Arteritis ◽  
Internal Carotid Arteries

scholarly journals Carotid Artery Stenosis and ischemic Strokes in Patients with Giant Cell Arteritis A characteristic Pattern - Literature Review and Case Report

TH Open ◽  
2021 ◽  
Author(s):  
Clemens Oerding ◽  
Frank Uhlmann ◽  
Ingmar Kaden ◽  
Johannes Wollmann ◽  
Kai Wohlfarth
Keyword(s):  
Carotid Artery ◽  
Literature Review ◽  
Internal Carotid Artery ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Carotid Artery Stenosis ◽  
Internal Carotid ◽  
Case Series ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis

Purpose: Ischemic stroke is a relatively rare complication of giant cell arteritis often accompanied by vessel stenosis. Our purpose was to compare the location of internal carotid artery stenosis in GCA patients by performing a literature review suggesting a specific and characteristic pattern. Methods: We performed a Pubmed research including all articles and cited articles reporting cases and case series about giant cell arteritis patients with internal carotid artery stenosis and ischemic strokes. Results: In this case series 39 cases were included. We found a clear tendency of giant cell arteritis related stenosis to be in the intracranial segments (35/39 (89,7 %)). Only in 8/39 (20,5 %) patients there was further involvement of extracranial segments. Many cases (27/39 (69,2 %)) showed a bilateral involvement. Discussion: This literature review reveals a specific pattern of internal carotid artery involvement in patients with giant cell arteritis and ischemic strokes. To our knowledge this pattern has not been reported as a sign strongly pointing towards giant cell arteritis before. We have not found case reports mentioning other common types of vasculitis reporting this involvement pattern. Conclusion: Internal carotid artery stenosis and ischemic stroke is a rare complication in patients with giant cell arteritis. Considering the characteristic features of bilateral distal internal carotid artery stenosis giant cell arteritis should be suspected which potentially leads to an early diagnosis and immunotherapy.

Hyperdense Middle Cerebral and/or Internal Carotid Arteries in Acute Ischemic Stroke: Rate, Predictive Factors and Influence on Clinical Outcome

2011 ◽  
Vol 32 (3) ◽  
pp. 239-245 ◽  
Author(s):  
Maurizio Paciaroni ◽  
Giancarlo Agnelli ◽  
Piero Floridi ◽  
Andrea Alberti ◽  
Monica Acciarresi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Acute Ischemic Stroke ◽  
Predictive Factors ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Stroke Rate ◽  
Internal Carotid Arteries

scholarly journals Progression of Mild to Moderate Stenosis in the Internal Carotid Arteries of Patients With Ischemic Stroke

2018 ◽  
Vol 9 ◽  
Author(s):  
Cheung-Ter Ong ◽  
Yi-Sin Wong ◽  
Sheng-Feng Sung ◽  
Chi-Shun Wu ◽  
Yung-Chu Hsu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Internal Carotid Arteries

scholarly journals A Grave Initial Presentation of Graves’ Disease in a Patient With Moyamoya

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A913-A913
Author(s):  
Courtney Clutter ◽  
Morgan Jordan
Keyword(s):  
Ischemic Stroke ◽  
Moyamoya Disease ◽  
Multinodular Goiter ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Graves Disease ◽  
Moyamoya Syndrome ◽  
The Right ◽  
Internal Carotid Arteries ◽  
The U.S

Abstract Background: Moyamoya syndrome is chronic stenoocclusive disease involving the intracranial internal carotid arteries and their proximal branches along with an associated condition, such as hyperthyroidism1. The concurrence of moyamoya and Graves’ disease is rare. Ischemic stroke in moyamoya syndrome is postulated to be precipitated by thyrotoxicosis-induced hemodynamic instability. Clinical Case: A 63-year old Korean female with history of moyamoya disease with two prior ischemic strokes, hypertension and type 2 diabetes mellitus presented to the ER with 6 hours of left leg weakness and involuntary arm movements. A code stroke was activated and neurologic examination was notable for left leg paresis and left arm stereotypy. CT head showed loss of gray-white matter differentiation in the right frontal lobe concerning for acute ischemia. CT angiography of the head and neck noted diffuse stenosis of intracerebral vasculature and significant stenosis of the cavernous and supraclinoid portions of the internal carotid arteries. MRI brain later confirmed an acute infarct in the right ACA distribution. Neuroimaging incidentally showed a multinodular goiter with a 1.7 cm right thyroid nodule. Subsequently TSH was obtained and resulted as <0.030 mcIU/mL (0.27-5.00 mcIU/mL) with a reflex FT4 of >7.00 ng/dL (0.6-1.8 ng/dL). A review of her prior TFTs showed biochemical euthyroidism. Due to iodinated contrast administration on admission, RAIU scan was deferred. Thyroid ultrasound showed multinodular goiter with diffuse increased vascularity and multiple TI-RADS 4 and 5 nodules bilaterally. On further questioning, the patient reported tachycardia, diarrhea, weight loss and decreased appetite prior to hospitalization. A diagnosis of Graves’ disease was confirmed with TSI of 70.7 IU/L (0.00-0.55 IU/L). She was started on methimazole 20 mg twice daily and propranolol 20 mg q6h. FT4 downtrend from >7.00 to 3.3 ng/dL at time of discharge. Following four weeks of methimazole 20 mg daily, FT4 normalized to 1.70 ng/dL. The patient chose to continue antithyroidal drug therapy for treatment of Graves’ disease. Conclusion: Thyroid function assessment should be considered when evaluating a patient with moyamoya and acute ischemic stroke. If moyamoya syndrome associated with Graves’ disease is identified, treatment should be aimed at maintenance of euthyroidism. Reference: 1. Scott RM, Smith ER. Moyamoya disease and moyamoya syndrome. N Engl J Med. 2009 Mar 19;360(12):1226-37. Disclaimer: The views expressed herein are those of the authors and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, the Department of the Air Force and Department of Defense or the U.S. Government.

DIFFICULTIES IN DIAGNOSING MOYA-MOYA DISEASE (CLINICAL CASE)

2020 ◽  
pp. 48-53
Author(s):  
Novikova I.N. ◽  
Popova T.F. ◽  
Gribacheva I.A. ◽  
Petrova E.V. ◽  
Marushchak A.A. ◽  
...  
Keyword(s):  
Cerebral Angiography ◽  
Neurological Disorders ◽  
Clinical Case ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Cerebral Arteries ◽  
Moya Moya Disease ◽  
Middle Cerebral Arteries ◽  
Internal Carotid Arteries ◽  
Made In

Moya-Moya disease is a rare progressive chronic cer-ebrovascular disease characterized by a narrowing of the lumen of the intracranial segments of the internal carotid arteries, as well as the initial segments of the anterior and middle cerebral arteries with the devel-opment of a network of small vascular anastomoses. Violations of blood supply due to occlusion lead to the development of ischemic strokes in the correspond-ing pools, and ruptures of vascular anastomoses - to the development of hemorrhagic strokes, causing a variety of neurological disorders. The article presents a clinical case of Moya-Moya disease in a 31-year-old patient. The disease was manifested by acute disorders of cerebral circulation in ischemic and hemorrhagic types. The diagnosis was made in accordance with the diagnostic criteria of the disease based on the data of endovascular cerebral angiography.

Sign in / Sign up

Export Citation Format

Share Document