Ischemic stroke as the first presentation of takayasu’s arteritis in young male

Gouda, Wesam; Alsaqabi, Faisal; Alkadi, Amjad; Amr, Hanan Abd El‐Aziz; Moshrif, A.; Mahdy, Mohammed

doi:10.1002/ccr3.2527

Cited by 9 publications

(16 citation statements)

References 9 publications

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“…1,2 Associa-se a alterações inflamatórias progressivas das paredes dos vasos, com espessamento difuso, estenoses e oclusões. 3,4 A sua etiologia ainda não está bem esclarecida.…”

Section: Discussionunclassified

“…A identificação e o tratamento precoce da AT têm como objetivo o controlo da atividade da doença a fim de reduzir a morbilidade e prevenir a ocorrência de complicações. 3 Acidentes vasculares cerebrais ou acidentes isquémicos transitórios são descritos em 10%-20% dos casos, sendo raramente a primeira manifestação da doença. 3,5 Descrevemos o caso de um AVC agudo numa jovem de 39 anos de idade, em que foi identificada oclusão da ACM, provavelmente decorrente de embolização artéria-artéria, atendendo a que não foram identificadas outras fontes embolígenas e à coexistência de uma estenose sub-oclusiva da ACC esquerda.…”

Section: Discussionunclassified

“…3 Acidentes vasculares cerebrais ou acidentes isquémicos transitórios são descritos em 10%-20% dos casos, sendo raramente a primeira manifestação da doença. 3,5 Descrevemos o caso de um AVC agudo numa jovem de 39 anos de idade, em que foi identificada oclusão da ACM, provavelmente decorrente de embolização artéria-artéria, atendendo a que não foram identificadas outras fontes embolígenas e à coexistência de uma estenose sub-oclusiva da ACC esquerda. Na fase aguda, foi submetida a fibrinólise endovenosa e trombectomia mecânica, após angioplastia por balão da estenose da ACC esquerda para acesso à ACM ocluída.…”

Section: Discussionunclassified

“…1 O envolvimento neurológico pode ocorrer em até 50% dos casos, incluindo, numa minoria, acidentes isquémicos transitórios e acidentes vasculares cerebrais. [3][4][5] Existe pouca evidência sobre a segurança das terapêuticas de reperfusão aguda no acidente vascular cerebral (AVC) isquémico em doentes com AT, havendo alguns relatos na literatura que descreveram a utilização eficaz destes procedimentos nesta patologia, sem aparentes complicações associadas. [6][7][8][9][10] Há que considerar, contudo, potenciais obstáculos decorrentes das alterações inflamatórias dos vasos, tornando mais difícil e problemática a execução destas técnicas.…”

Section: Introductionunclassified

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AVC Isquémico Agudo Secundário a Arterite de Takayasu: Como Abordar?

Marques¹

2020

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A arterite de Takayasu (AT) é uma doença inflamatória crónica, rara, e potencialmente devastadora. Cerca de 10% a 20% dos casos podem ser complicados por acidentes vasculares cerebrais (AVC) e/ou acidentes isquémicos transitórios. Neste artigo, descrevemos o caso de uma mulher de 39 anos de idade, admitida no serviço de urgência após a instalação súbita de sintomas sugestivos de AVC agudo, tendo sido submetida a fibrinólise endovenosa e terapêutica endovascular (angioplastia e trombectomia), com recuperação dos défices neurológicos. Não foram registadas complicações decorrentes do tratamento reperfusor. Apesar de, analisando retrospetivamente, a doente apresentar sinais e sintomas sugestivos de arterite de Takayasu, este diagnóstico só foi equacionado na abordagem endovascular, mediante a observação das alterações angiográficas típicas. Pretendemos acrescentar aos poucos relatos encontrados na literatura, um novo caso de AT em que as estratégias de reperfusão aguda foram usadas de forma segura e eficaz no tratamento do AVC isquémico. Adicionalmente reforçamos a necessidade de manter um elevado nível de suspeição, a fim de se considerar este diagnóstico no contexto clínico apropriado.

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“…1,2 Associa-se a alterações inflamatórias progressivas das paredes dos vasos, com espessamento difuso, estenoses e oclusões. 3,4 A sua etiologia ainda não está bem esclarecida.…”

Section: Discussionunclassified

Section: Introductionunclassified

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AVC Isquémico Agudo Secundário a Arterite de Takayasu: Como Abordar?

Marques¹

2020

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“…Diagnostic imaging techniques to visualize arterial stenosis are widely used in clinical practice. Importantly, however, most patients with TA are diagnosed in emergency settings because ischemic stroke is sometimes the first clinical manifestation of TA [19][20][21]. Therefore, it is important to suspect TA in cases of juvenile stroke.…”

Section: Importance Of Follow-up Vascular Imaging In Tamentioning

confidence: 99%

Vascular Imaging Techniques to Diagnose and Monitor Patients with Takayasu Arteritis: A Review of the Literature

Oura

Itabashi

et al. 2021

Diagnostics

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Takayasu arteritis (TA) is a large vessel vasculitis that causes stenosis, occlusion, and sometimes the aneurysm of the aorta and its major branches. TA often occurs in young women, and because the symptoms are not obvious in the early stages of the disease, diagnosis is difficult and often delayed. In approximately 10% to 20% of patients, TA is reportedly complicated by ischemic stroke or transient ischemic attack. It is important to diagnose TA early and provide appropriate treatment to prevent complications from stroke. Diagnostic imaging techniques to visualize arterial stenosis are widely used in clinical practice. Even if no signs of cerebrovascular events are present at the time of the most recent evaluation of patients with TA, follow-up vascular imaging is important to monitor disease progression and changes in the cerebrovascular risk. However, the optimal imaging technique for monitoring of TA has not been established. Therefore, the purpose of this review is to describe newly available evidence on the usefulness of conventional imaging modalities (digital subtraction angiography, computed tomography angiography, magnetic resonance imaging/angiography, duplex ultrasound, and positron emission tomography) and novel imaging modalities (optical coherence tomography, infrared thermography, contrast-enhanced ultrasonography, and superb microvascular imaging) in the diagnosis and monitoring of TA.

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Incidence, prevalence and risk of stroke in patients with Takayasu arteritis: a nationwide population-based study in South Korea

et al. 2021

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BackgroundTakayasu arteritis (TAK) is a disease associated with increased risk of cardiovascular complications. We aimed to evaluate the incidence, prevalence and risk of stroke in patients with TAK.MethodsData from 1065 patients were obtained from a national database (2010–2018). The annual incidence and prevalence per 100 000 persons were estimated using the registration population in the midst of every year, and the standardised incidence ratio (SIR) of stroke was compared with the general population based on the data from the 2006 national report for cardiovascular and cerebrovascular diseases. Age-adjusted incidence rate ratio (IRR) of stroke based on the time interval after diagnosis was also calculated. A time-dependent Cox regression was conducted to investigate predictive factors of stroke.ResultsThe overall incidence rate of TAK ranged between 0.2 and 0.3/100 000 person-years annually; the prevalence of TAK gradually increased, reaching 3.25/100 000 person-years in 2018. Seventy-three (6.9%) patients experienced stroke during follow-up, and the risk of developing stroke was higher than the general population (overall SIR 7.39, 95% CI 5.79 to 9.29; men: SIR 5.70, 95% CI 2.84 to 10.20; women: SIR 7.06, 95% CI 5.41 to 9.05). Most stroke events (90.9%) were cerebral infarction for men, whereas the proportion of cerebral infarction was lower (62.9%) in women. Over half of stroke events occurred within 6 months after diagnosis, and stroke was more common within 6 months of diagnosis compared with after 3 years in women (IRR 13.46, 95% CI 6.86 to 26.40). In Cox regression analysis, age was the sole predictor of stroke (adjusted HR 1.02, 95% CI 1.00 to 1.04, p=0.043).ConclusionsThe annual incidence of TAK was similar to the previous studies from Asia, and the risk of stroke increased in TAK. Different patterns of subtype and incidence of stroke were found according to sex, although age was the only predictor.

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Ischemic stroke as the first presentation of takayasu’s arteritis in young male

Abstract: Takayasu's arteritis should be kept under the differential diagnosis of stroke in all young patients. Early, proper diagnosis and treatment are necessary to reduce any further progression, morbidity, and mortality rates of the disease.

Cited by 9 publications

References 9 publications

AVC Isquémico Agudo Secundário a Arterite de Takayasu: Como Abordar?

AVC Isquémico Agudo Secundário a Arterite de Takayasu: Como Abordar?

Vascular Imaging Techniques to Diagnose and Monitor Patients with Takayasu Arteritis: A Review of the Literature

Incidence, prevalence and risk of stroke in patients with Takayasu arteritis: a nationwide population-based study in South Korea

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