Multiple strokes after initiation of steroid therapy in giant cell arteritis.
We report the case of a 66 year old woman with clinical manifestations of giant-cell arteritis, positive temporal artery biopsy and excellent response to prednisone, who developed massive cerebral infarcts after 5 days of treatment. Computed tomographic and magnetic resonance imaging scans revealed multiple infarcts in areas irrigated by both the carotid and vertebrobasilar systems bilaterally. A four-vessel angiography performed 19 days later revealed only mild atheromatous disease. Anticardiolipin antibodies were negative and a transoesophageal echocardiogram was normal. Stroke during the first 2 weeks of therapy in giant-cell arteritis, especially in the vertebrobasilar territory, has been previously reported. Anticoagulation during the first weeks of steroid treatment in these patients might be advisable.
Collazos
J
J
Section of Internal Medicine, Hospital de Galdácano, Vizcaya, Spain.
García-Moncó
C
C
Martín
A
A
Rodriguez
J
J
Gómez
M A
MA
D000368:Aged; D002544:Cerebral Infarction / Q000209:etiology; D002561:Cerebrovascular Disorders / Q000209:etiology*; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D011241:Prednisone / Q000627:therapeutic use*; D013997:Time Factors
D011241:Prednisone