Bilateral simultaneous amaurosis as onset and unique symptom in giant cell arteritis

Manea, Maria Mirabela; Dragoș, Dorin; Arsene, D; Tuță, Sorin

doi:10.1007/s13760-017-0877-5

Cited by 2 publications

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References 5 publications

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“…The occurrence of stroke in GCA patients is associated with a poor prognosis [ 7 , 15 , 16 , 20 ]. Furthermore, GCA may result in visual loss, if not adequately treated and the mainstay treatment relies on immunomodulatory therapy [ 31 ]. Therefore, it seems to be reasonable to use non-invasive methods to screen for GCA among patients with VB-stroke, especially in the presence of increased inflammatory markers, anemia and/or multiple vascular stenoses/occlusions in the VB-territory (as shown in Fig.…”

Section: Discussionmentioning

confidence: 99%

Red flags for a concomitant giant cell arteritis in patients with vertebrobasilar stroke: a cross-sectional study and systematic review

et al. 2020

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Giant cell arteritis (GCA) may affect the brain-supplying arteries, resulting in ischemic stroke, whereby the vertebrobasilar territory is most often involved. Since etiology is unknown in 25% of stroke patients and GCA is hardly considered as a cause, we examined in a pilot study, whether screening for GCA after vertebrobasilar stroke might unmask an otherwise missed disease. Consecutive patients with vertebrobasilar stroke were prospectively screened for GCA using erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), hemoglobin, and halo sign of the temporal and vertebral artery on ultrasound. Furthermore, we conducted a systematic literature review for relevant studies. Sixty-five patients were included, and two patients (3.1%) were diagnosed with GCA. Patients with GCA were older in age (median 85 versus 69 years, p = 0.02). ESR and CRP were significantly increased and hemoglobin was significantly lower in GCA patients compared to non-GCA patients (median, 75 versus 11 mm in 1 h, p = 0.001; 3.84 versus 0.25 mg/dl, p = 0.01, 10.4 versus 14.6 mg/dl, p = 0.003, respectively). Multiple stenoses/occlusions in the vertebrobasilar territory affected our two GCA patients (100%), but only five (7.9%) non-GCA patients (p = 0.01). Our literature review identified 13 articles with 136 stroke patients with concomitant GCA. Those were old in age. Headache, increased inflammatory markers, and anemia were frequently reported. Multiple stenoses/occlusions in the vertebrobasilar territory affected around 70% of stroke patients with GCA. Increased inflammatory markers, older age, anemia, and multiple stenoses/occlusions in the vertebrobasilar territory may be regarded as red flags for GCA among patients with vertebrobasilar stroke.

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Section: Discussionmentioning

confidence: 99%

Red flags for a concomitant giant cell arteritis in patients with vertebrobasilar stroke: a cross-sectional study and systematic review

et al. 2020

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“…An infectious etiology was excluded by performing serological tests for human immunodeficiency virus (HIV), syphilis, mycoplasma pneumoniae, herpes simplex or herpes zoster, all with negative results. Giant cell arteritis leading to amaurosis fugax in patients with normal clinical exam and normal lab results was reported before [10]. However, this diagnosis was unlikely due to the normal clinical exam; also, there were no abnormalities of the temporal artery at the ultrasound exam.…”

Section: Resultsmentioning

confidence: 78%

The crucial role of gadolinium-enhanced MRI in a case of amaurosis fugax – a case report and literature review

Manea,

Dragoş,

Dobri

et al. 2024

Romanian Journal of Internal Medicine

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Optic perineuritis is the inflammation of the optic nerve sheath. This affliction can lead to visual field impairment and other signs and symptoms related to the orbital space, such as pain, disc edema, ophthalmoplegia, proptosis. However, not all patients present with such suggestive symptoms, requiring a thorough assessment. We report the case of a young male admitted to our hospital for recurrent episodes of monocular blindness. Amaurosis fugax is a well-known presentation of transient ischemic attacks (TIA) and it was ruled out. Gadolinium-enhanced MRI revealed a typical aspect of optic perineuritis. It was mandatory to consider all possible causes of secondary optic perineuritis as they all represent serious clinical conditions, even if the idiopathic form is more frequent. The clinical and paraclinical evaluation of the patient excluded an underlying disease and primary optic perineuritis was diagnosed. Corticosteroid therapy is usually curative and a course of methylprednisolone was initiated for our patient with good outcome. However, response to treatment is not diagnostic as both primary and secondary optic perineuritis are normally responsive, hence thorough differential diagnosis is necessary.

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Bilateral simultaneous amaurosis as onset and unique symptom in giant cell arteritis

Cited by 2 publications

References 5 publications

Red flags for a concomitant giant cell arteritis in patients with vertebrobasilar stroke: a cross-sectional study and systematic review

Red flags for a concomitant giant cell arteritis in patients with vertebrobasilar stroke: a cross-sectional study and systematic review

The crucial role of gadolinium-enhanced MRI in a case of amaurosis fugax – a case report and literature review

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