A case of aortitis syndrome with bilateral middle cerebral arteries occlusion
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It is very uncommon that aortitis syndrome involves intracranial arteries of muscular type. The authors experienced such a very rare case of aortitis syndrome which accompanied occlusion of the bilateral middle cerebral arteries on angiogram. A 24 year-old woman was admitted to our hospital with chief complaints of cough, palpitation, chest pain and lumbago. At admission ESR was increased and CRP was positive. Angiography showed occlusion of the left pulmomary and the left renal arteries with stenosis of the abdominal descending aorta and the right renal artery. She was diagnosed as aortitis syndrome and treated mainly with administration of adrenal corticosteroids. Two years later she experienced TIA of three times consisting of dysarthria and motor weakness, and the first TIA was on the right limbs and the other ones on the left. The internal carotid angiograms at the second admission demonstrated occlusion of main trunk of the bilateral middle cerebral arteries.<BR>The occlusion of the arteries was most likely due to extension of arteritis from the following reasons; 1) ESR was accelerated and CRP was positive at the time of occurrence of TIAs, suggesting aggravation of inflammatory process. 2) In addition of bilateral middle cerebral arteries occlusion, irregularity or slight stenosis of the vessel was extensively noted in the intracranial arteries, suggesting progression of inflammatory process into the intracranial arteries. 3) No embolic source was verified in the bilateral common and internal carotid arteries and heart. 4) Arteriosclerotic process is less likely from her age.<BR>It is presumed that reports of the intracranial arteries involvement will be increased with spread clinical application of digital subtraction angiography.
- 一般社団法人 日本脳卒中学会の論文
一般社団法人 日本脳卒中学会 | 論文
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