title: Revisiting cerebral thromboangiitis obliterans.
abstract: We describe a 56-year-old patient with progressive cognitive decline in the context of heavy tobacco use and migraine, and imaging evidence of an occlusive terminal cerebral vasculopathy. The results of brain biopsy recapitulated the pathological features described by Lindenberg and Spatz in their classic 1939 treatise on cerebral thromboangiitis obliterans, or cerebral Buerger's disease. Although the condition is associated with heavy smoking, the identification of a hypercoagulable state in our patient suggests a multifactorial pathogenesis. The diagnosis of cerebral thromboangiitis obliterans in life is facilitated by modern neuroimaging and should prompt immediate cessation of smoking and a search for an underlying prothrombotic tendency.
authors.affiliation: Department of Neurology, Royal Prince Alfred Hospital, Missenden Road, Camperdown NSW 2050, Australia.
authors.forename: Carrie B
authors.initials: CB
authors.lastname: Hurelbrink
authors.forename: Yael
authors.initials: Y
authors.lastname: Barnett
authors.forename: Michael E
authors.initials: ME
authors.lastname: Buckland
authors.forename: Mark
authors.initials: M
authors.lastname: Wilkinson
authors.forename: Jon
authors.initials: J
authors.lastname: Leicester
authors.forename: Craig
authors.initials: C
authors.lastname: Anderson
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Brennan
authors.forename: Michael
authors.initials: M
authors.lastname: Barnett
mesh_terms: D001241:Aspirin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects / Q000473:pathology; D016540:Smoking Cessation / Q000379:methods; D013919:Thromboangiitis Obliterans / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*
chemical_list: D001241:Aspirin