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

Clemens Oerding; Ingmar Kaden; Kai Wohlfarth

doi:10.1159/000504018

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

Case Rep Neurol. 2020 Feb 21;12(1):84-91. doi: 10.1159/000504018. eCollection 2020 Jan-Apr.

Authors

Clemens Oerding¹, Ingmar Kaden², Kai Wohlfarth¹

Affiliations

¹ Department of Neurology, BG-Hospital Bergmannstrost, Halle (Saale), Germany.
² Department of Radiology, BG-Hospital Bergmannstrost, Halle (Saale), Germany.

Abstract

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.

Keywords: Cerebral revascularization; Cranial arteritis; Giant cell arteritis; Horton's disease; Internal carotid artery stenosis; Ischemic stroke; Temporal arteritis; Vasculitis; Vessel stenosis.

Publication types

Case Reports