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Case Reports
. 2011 Oct;14(4):304-6.
doi: 10.4103/0972-2327.91960.

An unusual case of Takayasu's arteritis: Evaluation by CT angiography

Mukund Vidhate  1 , Ravindra Kumar Garg, Rajesh Yadav, Neera Kohli, Praveen Naphade, H K Anuradha
Affiliations
Case Reports

An unusual case of Takayasu's arteritis: Evaluation by CT angiography

Mukund Vidhate et al. Ann Indian Acad Neurol. 2011 Oct.

Abstract

Takayasu's arteritis is a chronic, idiopathic, medium and large vessel vasculitis involving aorta and its main branches. Frequent neurological manifestations include postural syncope, seizures, and blindness. Stroke, as presenting feature of Takayasu's arteritis, is unusual. CT angiography reveals characteristic involvement of aortic arch and its branches. Involvement of intracranial vasculature is rather unusual. We are describing an unusual patient of Takayasu's arteritis who presented with recurrent disabling syncopal attacks and had extensive involvement of intracranial vasculature. CT angiography revealed severe involvement of aortic arch. There was near complete occlusion at origins of both subclavian arteries, distal flow was maintained by collateral vessels along the chest wall. There was near total occlusion (at origin) of right common carotid with normal flow in distal part. The left common carotid was more severely involved showing greater than 80% narrowing in proximal half of the vessel. CT angiography also revealed involvement of left internal carotid artery, narrowing of left middle cerebral artery and involvement of cortical vessels. Patient was treated with oral corticosteroids. She improved remarkably after two and half months of follow up.

Keywords: Takayasu's arteritis; stroke; vasculitis.

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Conflict of interest statement

Conflict of Interest: Nil.

Figures

Figure 1
Figure 1
Three dimensional CT aortic angiography showing total occlusion of origin of bilateral subclavian arteries (arrows), distal flow established by collaterals
Figure 2
Figure 2
Three dimensional CT angiography showing occlusion at origin of right common carotid artery with normal flow in distal extracranial and intracranial portion of right internal carotid artery (arrows); left common carotid artery showing involvement of both proximal and distal extracranial portion (arrowheads)
Figure 3
Figure 3
CT angiography at circle of Willis showing irregular narrowing of M1 portion of left middle cerebral artery (arrows) with decreased filling of left sided cortical vessels (arrowheads). Left posterior cerebral artery was normal
See this image and copyright information in PMC

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