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Query: UMLS:C0039483 (giant cell arteritis)
 3,204 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dementia occurs infrequently in patients with giant cell (temporal) arteritis (GCA). Three elderly women with biopsy-proven GCA showed abrupt cognitive decline during periods of clinically active GCA, 1 to 6 months after diagnostic temporal artery biopsy, during periods of corticosteroid taper. One patient had additional clinical signs of cerebral infarction and other ischemic phenomena. Reinstitution of higher oral doses of corticosteroids successfully prevented further cognitive losses and permitted gradual but incomplete improvement of cognitive function in 1 patient. Neuropsychologic data from 2 patients 7 to 10 months after temporal artery biopsy suggested multifocal cognitive impairment, and the 3rd patient appeared clinically to be globally, severely demented. Neuroimaging studies revealed multiple areas of infarction, predominantly in the posterior circulation territory. One patient had bilateral vertebral artery occlusions (digital subtraction angiography) and bilaterally reduced carotid system perfusion pressures (oculoplethysmography). There were no associated cardiovascular risk factors or family history of dementia in these patients.
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PMID:Giant cell (temporal) arteritis: a treatable cause of multi-infarct dementia. 233 Jan

A 75-year-old man with the simultaneous onset of Graves' disease and giant cell arteritis is described. Although there have been few previous reports of simultaneous onset, literature review and a retrospective study of the records of this hospital suggest that the association of Graves' disease and the polymyalgia rheumatica-giant cell arteritis syndrome is not simple coincidence. The patient's course was complicated by cerebral infarction secondary to either arterial thrombo-embolism or arteritis.
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PMID:Autoimmune thyroid disease and giant cell arteritis: a review, case report and epidemiological study. 659 62

Six cases of arterial insufficiency of the arm secondary to giant cell arteritis are described, all in elderly white women. The clinical presentation of the occlusive disease ranged from an asymptomatic incidental physical finding to an alarming picture of severe ischemia. All patients were treated with steroids and had subsequent stabilization or improvement of extremity symptoms. Vascular reconstruction was also performed in two patients, one of whom developed rest pain after graft occlusion. Another patient had a cerebral infarction while taking prednisone, despite control of large vessel vasculitis. This study indicates that giant cell arteritis should be considered in cases of occlusive disease of the arms, especially in elderly women. Giant cell arteritis is a seriously morbid and potentially fatal disease which justifies a thorough evaluation when sufficient evidence is present to suggest the diagnosis. The response to steroids is usually adequate to eliminate the need for early surgical intervention.
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PMID:Arm ischemia secondary to giant cell arteritis. 708 59

We describe a 59-year-old Japanese man with rare complications of giant cell arteritis. He presented with aortic insufficiency due to dilatation of the aortic root. Nine years after the occurrence of aortic insufficiency, he suffered from a cerebral infarction due to occlusion of the left middle and anterior cerebral arteries, showing giant cell arteritis.
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PMID:Giant cell arteritis involving the cerebral artery. 832 39

Horton's disease is a giant cell arteritis well known for its presentation as temporal arteritis. It is, in fact, a systemic disease which affects over 1% of the general populations after 50 years of age. With the exception of the risk of blindness by occlusion of the ophthalmic artery, the cardiovascular manifestations of Horton's disease are not well known and probably underestimated by clinicians. The main complications are involvement of the large arteries, especially the thoracic aorta and subclavian and axillary arteries, the femoro-popliteal axis and supra-aortic arterial vessels. During the initial phase of the disease, extension of arteritis to the carotid and vertebral arteries is of particular concern because of the risk of cerebral infarction. The coronary arteries, myocardium, pericardium of pulmonary arteries may also be affected by the inflammatory process. In the long-term, Horton's disease may be complicated by aneurysms, dissection of parietal rupture of the thoracic aorta. Treatment is based on steroid therapy, sometimes associated with antiplatelet agents or anticoagulants during the initial phase of treatment. Long-term follow-up is justified because of the risk of late aortic complications.
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PMID:[Cardiovascular manifestations of Horton disease: an underestimated disease in cardiology]. 953 41

Internal carotid artery involvement and dementia occur infrequently in patients with giant cell (temporal) arteritis. A 75-year-old woman admitted with progressive cognitive decline, drowsiness and headache was diagnosed as having giant cell arteritis by temporal artery biopsy (TAB). High dose corticosteroid improved inflammatory reaction but did not improve his cognitive function. Cerebral angiograms showed obstruction of both internal carotid arteries at the siphon. Brain MRI showed only small cerebral infarcts in the basal ganglia and corona radiata bilaterally. However, brain SPECT disclosed reduced cerebral blood flow in the frontal lobe bilaterally. A postmortem examination revealed bilateral parietal infarcts and isolated giant cell arteritis involving the both internal carotid arteries at the siphon. We speculated that perfusion insufficiency and multiple cerebral infarction due to bilateral internal carotid artery occlusion had caused this neurologic deterioration.
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PMID:[Giant cell arteritis with bilateral obstruction of the internal carotid artery--report of an autopsy case]. 974 80

The objective of this report was to explore the clinical features of patients with cerebral infarction due to giant cell (temporal) arteritis (GCA) and its characteristic changes in pathology, and on computed tomography (CT) and magnetic resonance imaging (MRI). Three cases of cerebral infarction due to GCA, treated during the past 2 years, were analyzed. Their clinical manifestations were observed carefully, their temporal artery biopsies were performed, their immunohistochemistries were done, and CT as well as MRI were used. The results showed that all the patients had new-onset headache and temporal artery abnormality when the disease began, and there was tremor on the right limbs of 1 patient; temporal artery biopsies revealed evidence of inflammatory cell infiltration in the arterial wall, mainly including T-lymphocytes and macrophages; small cerebral infarction foci were found on CT and MRI; and the responses to corticosteroid therapies were good. The results suggest that it is important to recognize the clinical features of cerebral infarction due to GCA, including the changes of pathology and on CT and MRI. In some cases, special attention is paid to differentiating between atherosclerotic infarction and infections to avoid misdiagnosis.
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PMID:Cerebral infarction due to giant cell arteritis-three case reports. 1502 81

Cerebrovascular accidents (CVAs) and multi-infarct dementia have rarely been reported as presenting symptoms of giant cell arteritis (GCA), although 3%-4% of patients with GCA may present with CVAs during the course of the disease. We describe 7 patients with biopsy-proven GCA who presented with stroke or multi-infarct dementia. Most of them had other symptoms of GCA when the disease began that were misdiagnosed or not noticed. The internal carotid arteries were involved in 4 patients and the vertebrobasilar arteries in 3, with bilateral vertebral artery occlusion in 1. Small cerebral infarction foci on cranial computed tomography (CT) scan and magnetic resonance imaging (MRI) were found in 5 cases, and cerebellar infarction, in 2. MR angiography showed intracranial arteritis in 4 cases. Treatment with glucocorticoids and adjunctive antiplatelet or anticoagulant therapy was given in all cases, with neurologic improvement in 5. Two patients died. Necropsy demonstrated generalized GCA involving the medium and small cerebral vessels in 1 case. Central nervous system involvement is a rare complication in GCA but is important to recognize, as it can be reversible if diagnosed and treated promptly. Suspicion should arise in elderly patients suffering from strokes with a quickly progressing stepwise course and associated headache, fever, or inflammatory syndrome. In these cases, temporal artery biopsy should be performed without delay. Early diagnosis of GCA and immediate initiation of corticosteroid treatment may prevent progressive deterioration and death. Additional antiplatelet or anticoagulant therapy should be evaluated according to the individual risk and benefit to the patient under care.
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PMID:Stroke and multi-infarct dementia as presenting symptoms of giant cell arteritis: report of 7 cases and review of the literature. 1901 5

A 24-year-old man presented with a ten-day history of severe headache leading to collapse. CT studies showed filling defects involving the anterior, middle and posterior cerebral arteries and evidence of ischemia and infarction. Post-mortem examination revealed multiple cerebral infarcts secondary to an arteritic process composed of multi-nucleated giant cells, lymphocytes and histiocytes in both middle and anterior cerebral arteries and one posterior cerebral artery. Both carotid siphons and one renal artery segment were also involved. Extensive workup and stains for systemic and infectious causes were negative, leading to a diagnosis of atypical giant cell arteritis (GCA). Disseminated GCA involving extracranial arteries and the anterior, middle and posterior cerebral arteries leading to cerebral infarction has not been previously reported. We report this atypical case of disseminated GCA in a young patient with clinical features distinct from classic GCA (temporal arteritis) and discuss the differential diagnosis.
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PMID:A 24-year-old male with headaches. 2062 48

We report a middle-aged woman presenting with acute confusion and anterograde amnesia. Magnetic resonance imaging revealed an acute infarction of the anterior genu fornices. Evaluation of an elevated erythrocyte sedimentation rate led to the diagnosis of giant cell arteritis (GCA). Cerebral infarction is a known complication of GCA; this is the first report of such an association with selective fornix infarction.
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PMID:Selective infarction of the anterior genu fornices associated with giant cell arteritis. 2088 44


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