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Updates in the diagnosis and management of Takayasu's arteritis
This article aims to describe to the reader key features of Takayasu's arteritis and highlights updated evidence in the diagnosis and management of these patients. We also review the 2021 ACR guidelines for Takayasu's arteritis and correlate them to the updated evidence discussed throughout the review. An extensive literature search was conducted via PUBMED, including the words 'Takayasu's diagnostic criteria,' 'Takayasu's treatment,' 'Takayasu's diagnosis,' 'Takayasu's imaging', and 'Takayasu's diagnostic criteria.' Search was filtered to include clinical trials, randomized controlled trials, systematic reviews, and meta-...
Source: Postgraduate Medicine - January 2, 2023 Category: Internal Medicine Authors: Anupam Somashekar Yiu Tak Leung Source Type: research

Giant cell arteritis with stroke and systemic diffuse vasculitis
C Lu, S Zhou, C Yang, J YeJournal of Postgraduate Medicine 2022 68(4):233-235 Giant cell arteritis (GCA) is a systemic vasculitis, which mainly affects the aorta and its branches, while the abdominal aorta, the iliac artery and the limbs involvement are rare. The common clinical manifestations include headache, fever, jaw claudication, and visual impairment. Cerebrovascular accidents are relatively rare. Here, we present a GCA patient with stroke and systemic diffuse vasculitis involving the abdominal aorta, iliac artery, and femoral artery simultaneously.
Source: Journal of Postgraduate Medicine - November 4, 2022 Category: Internal Medicine Authors: C Lu S Zhou C Yang J Ye Source Type: research

Value of vessel wall magnetic resonance imaging in the diagnosis and management of cerebrovascular diseases
ConclusionIntracranial vessel wall MR imaging is an adjunct to conventional angiographic imaging
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Isolated Cerebral Vasculitis in the Unilateral Middle Cerebral Artery in a Case with SLE.
Authors: Takeshita S, Ogata T, Tsugawa J, Tsuboi Y Abstract A 47-year-old woman, who was diagnosed to have systemic lupus erythematosus (SLE), was admitted because she suffered a severe ischemic stroke three weeks after experiencing a transient attack of aphasia. Diffusion-weighted MR imaging revealed high intensity at the borderzone of the middle cerebral artery (MCA), while the proximal portion of the left MCA was occluded with its vascular wall enhanced by gadolinium. Intravenous methylprednisolone and heparin were administrated without any symptomatic benefit. She developed severe right hemiparesis with aphasia...
Source: Internal Medicine - July 29, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

A Rare Case Series of Ischemic Stroke Following Russell's Viper Snake Bite in India.
Authors: Pothukuchi VK, Kumar A, Teja C, Verma A Abstract Snakebite is an important medical problem in India. Among their various manifestations, cerebral complications are uncommonly found in literature. Moreover, Ischemic stroke following snake bite is quite rare. Here we report a case series of two such cases that developed neurological manifestations following Russell's viper bite. On computerized tomography (CT) scan of brain; cerebral infarcts were revealed. Their likely mechanisms are discussed in present study which include disseminated intravascular coagulation, toxin induced vasculitis and endothelial dam...
Source: Acta medica Indonesiana - January 21, 2018 Category: Internal Medicine Tags: Acta Med Indones Source Type: research

Multiple facets of ADA2 deficiency: Vasculitis, auto-inflammatory disease and immunodeficiency: A literature review of 135 cases from literature.
Authors: Fayand A, Sarrabay G, Belot A, Hentgen V, Kone-Paut I, Grateau G, Melki I, Georgin-Lavialle S Abstract Deficiency of adenosine deaminase 2 (DADA2) is a recently described auto-inflammatory disorder. It is an autosomal recessive inherited disease, caused by mutations in the ADA2 gene (formerly known as CECR1) encoding ADA2 enzyme. Besides its role in the purine metabolism, it has been postulated that ADA2 may act as a growth factor for endothelial cells and in the differenciation of monocytes. Thus, deficiency of ADA2 would lead to endothelial damage and a skewing of monocytes into M1 pro-inflammatory macro...
Source: Revue de Medecine Interne - December 25, 2017 Category: Internal Medicine Tags: Rev Med Interne Source Type: research

Giant cell arteritis: beyond temporal artery biopsy and steroids
Giant cell arteritis is the most common primary vasculitis of the elderly. The acute complications of untreated giant cell arteritis, such as vision loss or occasionally stroke, can be devastating. The diagnosis is, however, not altogether straightforward due to variable sensitivities of the temporal artery biopsy as a reference diagnostic test. In this review, we discuss the increasing role of imaging in the diagnosis of giant cell arteritis. Glucocorticoid treatment is the backbone of therapy, but it is associated with significant adverse effects. A less toxic alternative is required. Conventional and novel immunosuppres...
Source: Internal Medicine Journal - November 5, 2017 Category: Internal Medicine Authors: Jem V. Ninan, Susan Lester, Catherine L. Hill Tags: Review Source Type: research

Giant Cell Arteritis – Beyond temporal artery biopsy and steroids
Abstract Giant cell arteritis is the commonest primary vasculitis of the elderly. The acute complications of untreated Giant cell arteritis such as vision loss or occasionally stroke can be devastating. The diagnosis is however not altogether straightforward due to variable sensitivities of the temporal artery biopsy as a reference diagnostic test. In this review, we discuss the increasing role of imaging in the diagnosis of Giant cell arteritis. Glucocorticoid treatment is the backbone of therapy but it is associated with significant adverse effects. A less toxic alternative is required. Conventional and novel immunosuppr...
Source: Internal Medicine Journal - May 9, 2017 Category: Internal Medicine Authors: Jem V Ninan, Susan Lester, Catherine L Hill Tags: Review Source Type: research

Intracranial dermoid cyst rupture-related brain ischemia: Case report and hemodynamic study
Rationale: Spontaneous rupture of intracranial dermoid cyst is a rare but serious clinical event that can result in cerebral ischemia. Cerebral vasospasm and vasculitis are considered as potential mechanisms of dermoid cyst rupture-related cerebral ischemia. However, the hemodynamic mechanisms between cerebral ischemia and dermoid cyst rupture are not well known. Patient concerns: A 55-year-old, right-handed man was admitted to our hospital with sudden receptive aphasia and right-sided hypoalgesia. Brain magnetic resonance imaging (MRI) revealed a ruptured dermoid cyst and watershed infarcts in the left hemisphere. Then b...
Source: Medicine - January 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

An Update of the Mayo Clinic Cohort of Patients With Adult Primary Central Nervous System Vasculitis: Description of 163 Patients
This study is based on a cohort of 163 consecutive patients with PCNSV who were examined at the Mayo Clinic over a 29-year period from 1983 to 2011. The aim of the study was to define the characteristics of these patients, which represents the largest series in adults reported to date. A total of 105 patients were diagnosed by angiographic findings and 58 by biopsy results. The patients diagnosed by biopsy more frequently had at presentation cognitive dysfunction, greater cerebrospinal fluid total protein concentrations, less frequent cerebral infarcts, and more frequent leptomeningeal gadolinium-enhanced lesions on magnet...
Source: Medicine - May 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Extra- and Intracranial Cerebral Vasculitis in Giant Cell Arteritis: An Observational Study
Abstract: Recognizing giant cell arteritis (GCA) in patients with stroke may be challenging. We aimed to highlight the clinical spectrum and long-term follow-up of GCA-specific cerebrovascular accidents. Medical charts of all patients followed in a French Department of Internal Medicine for GCA between January 2008 and January 2014 were retrospectively reviewed. Patients with cerebrovascular accidents at GCA diagnosis were included. Diagnosis of GCA was based on American College of Rheumatology criteria. Transient ischemic attacks and stroke resulting from an atherosclerotic or cardioembolic mechanism were excluded. Clinic...
Source: Medicine - December 1, 2014 Category: Internal Medicine Tags: Article: Observational Study Source Type: research

Cerebral arterial infarction in inflammatory bowel diseases.
Abstract It has been estimated that up to 10% of hypercoagulable state manifestations in patients with inflammatory bowel disease (IBD) are ischemic strokes. The literature search through MEDLINE and EMBASE highlighted 33 case reports of IBD patients complicated with cerebral arterial infarction during the course of their disease. Most of these patients presented with either left or right sided hemiparesis on admission, while the most common site of arterial infarction was either the right or the left middle cerebral artery. Thrombocytosis and anemia were the most commonly observed potential risk factors for strok...
Source: European Journal of Internal Medicine - September 9, 2013 Category: Internal Medicine Authors: Katsanos AH, Kosmidou M, Giannopoulos S, Katsanos KH, Tsivgoulis G, Kyritsis AP, Tsianos EV Tags: Eur J Intern Med Source Type: research

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