Nota Clínica

Stroke as the first manifestation of temporal arteritis: three case reports and a review of its pathogenesis and treatment

A. Belenguer-Benavides, C. Vilar, D. Geffner-Sclarsky [REV NEUROL 2004;39:227-232] PMID: 15284962 DOI: https://doi.org/10.33588/rn.3903.2004096

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Volumen 39 | Number 03 | Nº of views of the article 20.328 | Nº of PDF downloads 1.043 | Article publication date 01/08/2004

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ABSTRACT

INTRODUCTION Giant cell arteritis (GCA) is the most common form of systemic vasculitis in adults and is predominant in females. The incidence of the disease increases with age, reaching approximately 70.1 cases per 100 000 inhabitants in patients over the age of 80. A stroke is an unusual presenting symptom of GCA and has a very poor associated prognosis, especially at the vertebrobasilar level. CASE REPORTS. We present three case reports involving patients aged between 70 and 82, who were diagnosed as suffering from temporal arteritis after a stroke. In all cases the most frequent symptoms of the disease (headaches, jaw claudication, constitutional symptoms, fever, night sweats, asthenia, anorexia or loss of weight) went undetected until the ischemic stroke. In one of the cases the progression of the stroke led to the patient’s death within the first 24 hours; in the other two cases, however, corticoid therapy was started and the initial response was good. In the three patients a final diagnosis was reached after a pathology study of the temporal artery. The presence of normal ESR in one of the cases was not a contraindication to performing a temporal biopsy.

CONCLUSIONS Temporal arteritis is an infrequent cause of ischemic stroke. Yet, due to its ominous prognosis it is important to identify the main signs of the disease and to take it into account in the differential diagnosis of ischemic stroke in the elderly. KeywordsCerebrovascular disorders Giant cell arteritis Pathogenesis Temporal arteritis Therapy CategoriesPatología vascular

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Nota Clínica

Stroke as the first manifestation of temporal arteritis: three case reports and a review of its pathogenesis and treatment