Ischemic stroke in giant-cell arteritis: French retrospective study

Pariente, A.; Guédon, A.; Alamowitch, Sonia; Thietart, Sara; Carrat, Fabrice; Delorme, S.; Capron, Jean; Cacciatore, Carlotta; Soussan, Michaël; Dellal, Azeddine; Fain, Olivier; Mékinian, A.

doi:10.1016/j.jaut.2019.01.009

Cited by 40 publications

(46 citation statements)

References 17 publications

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“…Along with our case in previous studies, diabetes, arterial hypertension, and hyperlipidemia were more common in GCA patients developing stenosis rather than in GCA patients without stenosis [6,7] thus atherosclerosis might contribute to the mechanisms causing ischemic strokes in GCA patients. An emphasized treatment of these risk factors should be considered equally as important as in patients with ischemic strokes of sole atherosclerotic origin.…”

Section: Discussionsupporting

confidence: 86%

“…Diagnosis can be challenging due to a variable presentation concerning both clinical and radiological findings. Ischemic stroke is a complication of GCA, occurring in about 4-16% of the patients (partly depending on the conditions under which the strokes were considered GCA-related) [2][3][4][5][6]. Although in most studies, an obligatory inclusion criterion is temporal-artery-biopsy-proven (TAB)-GCA [3,7] or GCA diagnosis according to ACR criteria (see Table 1), this disease can occur without STA-involvement and new onset headache, scalp tenderness, jaw claudication, or loss of vision [1,8].…”

Section: Introductionmentioning

confidence: 99%

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

2020

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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.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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

2020

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“…Stroke has been described before as a complication of GCA. In a new French study, the patients with GCA and stroke were more often older and more frequently men compared to patients with GCA and no strokes (4). This is in contrast to the sex distribution in GCA, where women are affected more often.…”

Section: Discussionmentioning

confidence: 87%

“…(3) Temporal artery tenderness. (4) Erythrocyte sedimentation rate >40 mm/h. (5) Positive biopsy of the superficial temporal artery.…”

Section: Methodsmentioning

confidence: 99%

Endovascular Treatment of Intracerebral Giant Cell Arteritis

et al. 2020

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Background: Giant cell arteritis (GCA) is the most common primary systemic vasculitis predominantly affecting large and medium sized vessels. In rare cases, the vasculitis can affect the vessels of the brain. Results: We describe four cases of GCA with involvement of the cerebral vessels causing stroke. These cases were unresponsive to aggressive immunosuppression and we opted to treat with endovascular balloon dilatation of the stenotic areas. The procedure was safe. The four patients were treated in nine sessions and a total of 16 vessels were treated. We observed two dissections with no clinical influence on the patients. Discussion: In patients with stroke due to progressive GCA that is non-responsive to immunosuppression, endovascular therapy is feasible.

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“…Furthermore, he developed epilepsy and transient ischemic attack as the initial symptoms, which were believed to have developed due to left internal carotid artery occlusion. Previous studies have reported that carotid artery lesion is found in 41% patients with GCA [11] and ischemic stroke occurs in 2-16% [12].…”

Section: Discussionmentioning

confidence: 92%

3-Tesla magnetic resonance imaging reveals vasculitis-caused otitis media in a patient with giant cell arteritis

Aoki

Fujikawa

Umezawa

et al. 2021

Acta Oto-Laryngologica Case Reports

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Giant cell arteritis (GCA), a medium to large-vessel vasculitis, has a broad spectrum of disease manifestations, including hearing loss. In addition to tissue histology, clinical correlation of symptoms and vascular imaging is optimal for a definitive diagnosis of GCA. Here, we describe an extremely rare case of GCA with hearing loss and otitis media, wherein contrast-enhanced 3 D-magnetic resonance imaging was acquired at 3-Tesla for assessment of inflammatory involvement of cranial arteries. Spin-echo imaging demonstrated mural thickening and contrast enhancement of the medial meningeal artery in addition to the superficial temporal artery on the left side. Simultaneously, gradient-echo imaging revealed intense enhancement in the fallopian canal and eustachian tube on the left side, which was associated with non-enhanced effusion in the mastoid cavity. The findings suggest a broad distribution of arterial inflammation in the temporal bone, including small vessel vasculitis, which may cause otologic manifestations in cranial GCA.

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Ischemic stroke in giant-cell arteritis: French retrospective study

Cited by 40 publications

References 17 publications

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

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

Endovascular Treatment of Intracerebral Giant Cell Arteritis

3-Tesla magnetic resonance imaging reveals vasculitis-caused otitis media in a patient with giant cell arteritis

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