Association Between Cerebrovascular Accident and Vasculitis: Myth or Reality?

Abstract

This article aims to determine an association between vasculitis and cerebrovascular accidents (CVA) and the ideal management plan to decrease the chances of CVA in vasculitis patients. We also attempt to find a preferred treatment regimen that decreases the complications of CVAs in vasculitis patients, thereby resulting in reduced mortality and morbidity. We reviewed both free-access full-text articles and the abstracts of articles behind a paywall. We used the PubMed database and reviewed 89 articles that matched our inclusion and exclusion criteria. In all, 42 out of the 89 articles had the most relevant data for our article. We used the following keywords to search the database: vasculitis, stroke, cerebrovascular accident, ischemic, arteritis, and steroid. We found an association between subtypes of vasculitis, mostly large vessel vasculitis and CVA. We could not identify a specific cutoff value for specific inflammatory markers that can increase the risk of developing CVA. Besides, there are no formal guidelines for the dosage or the route of administration for corticosteroids, which are the cornerstone of treatment for most vasculitis. We found that male giant cell arteritis (GCA) patients have a higher chance of developing CVA than females, Also interestingly, anemia was found to be protective against CVA development in GCA patients. Sometimes, CVA can happen due to the effects of treatments of some types of vasculitis. We recommend establishing further studies about other subtypes of vasculitis and their associations with stroke.

Relationship Between Cerebrovascular Diseases and Vasculitis: A Cross-Sectional Nationwide Inpatient Study

“…Of all types of vasculitis, patients with primary central nervous system angiitis have the highest risk (40%) of developing CVD [ 14 ]. About 6% of patients with systemic necrotizing vasculitis and 3% to 7% of patients with GCA developed CVD while over 10% of patients with Takayasu arteritis (TA) experienced ischemic stroke [ 11 , 15 , 16 ]. There is limited data and inadequate literature on risk factors that may predispose CVD in vasculitis patients.…”

Large Vessel Vasculitis in a Patient with Systemic Lupus Erythematosus Presenting as Takayasu’s Pulseless Arteritis

“…Etiologies of strokes range from cardio embolic phenomena, atherosclerosis and inflammatory diseases [5]. Vasculitis can lead to aneurysm formation or stenoses of the affected blood vessels which can result in limitation of blood flow to the brain resulting in stroke [6].…”