Artigo
Stroke as the First Clinical Manifestation of Takayasu's Arteritis
Registro en:
Case Reports in Neurology, v. 6, n. 3, p. 271-274, 2014.
1662-680X
10.1159/000369783
1497433265390194
2509669059614332
8758041511594882
2925649195052339
0979405137509692
Autor
Caldeira Pereira, Vanessa
Freitas, Carlos Clayton Macêdo de [UNESP]
Luvizutto, Gustavo José
Lima Sobreira, Marcone
Escobar Bueno Peixoto, Daniel
Do Nascimento MagalhÃes, Inaldo
Bazan, Rodrigo
Pereira Braga, Gabriel
Resumen
Takayasu's arteritis is a chronic inflammatory disease, and neurological symptoms occur in 50% of cases, most commonly including headache, dizziness, visual disturbances, convulsive crisis, transient ischemic attack, stroke and posterior reversible encephalopathy syndrome. The aim of this study was to report the case of a young Brazilian female with a focal neurological deficit. She presented with asymmetry of brachial and radial pulses, aphasia, dysarthria and right hemiplegia. Stroke was investigated extensively in this young patient. Only nonspecific inflammatory markers such as velocity of hemosedimentation and C-reactive protein were elevated. During hospitalization, clinical treatment was performed with pulse therapy showing improvement in neurological recuperation on subsequent days. In the chronic phase, the patient was submitted to medicated angioplasty of the brachiocephalic trunk with paclitaxel, with significant improvement of the stenosis. At the 6-month follow-up, the neurological exam presented mild dysarthria, faciobrachial predominant disproportionate hemiparesis, an NIHSS score of 4 and a modified Rankin Scale score of 3 (moderate incapacity). In conclusion, Takayasu's arteritis must be recognized as a potential cause of ischemic stroke in young females. Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, Botucatu, Rubiao Junior, Rubião Junior, CEP 18600000, SP, Brasil Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, Botucatu, Rubiao Junior, Rubião Junior, CEP 18600000, SP, Brasil