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Chapter 1.2 - Primary Systemic Vasculitis

from 1 - Inflammatory Conditions

Published online by Cambridge University Press:  06 October 2022

Anita Arsovska
Affiliation:
University of Ss Cyril and Methodius
Derya Uluduz
Affiliation:
Istanbul Üniversitesi
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Summary

Giant Cell Arteritis is a systemic vasculitis of unknown etiology that involves medium and large-sized vessels and has a tendency to involve extracranial branches of the carotid arteries. Ischemic complications of giant cell arteritis occur generally in patients with a yet undiagnosed or uncontrolled disease. Most common vascular complications are: anterior ischemic optic neuropathy, large-artery stenoses and ischemia, and, aortic aneurysms and dissections. Acute cerebrovascular ischemic events are a rare and severe complication of giant cell arteritis. The aim of this case report is to present a case of giant cell arteritis as a cause of stroke. The treatment of giant cell arteritis most commonly includes corticosteroids, but alternative therapy with corticosteroid sparing agents such as methotrexate, azathioprine, or tocilizumab, are available too. The treatment of acute stroke includes standard revascularization treatments in eligible patients (systemic thrombolysis and/or mechanical thrombectomy), as well as treatment in a stroke unit. In patients with giant cell arteritis who suffer stroke, secondary stroke prevention treatment is required as well as control of modifiable stroke risk factors. Antiplatelet therapy is cornerstone of the stroke prevention in majority of these patients, except in patients with cardioembolic stroke (particularly atrial fibrillation), where an oral anticoagulant therapy is recommended

Type
Chapter
Information
Rare Causes of Stroke
A Handbook
, pp. 10 - 16
Publisher: Cambridge University Press
Print publication year: 2022

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