title: Unilateral symptomatic intracranial arterial stenosis and myopathy in an adolescent with Graves disease: a case report of an high-resolution magnetic resonance imaging study.
abstract: Vascular and muscular involvements in Graves disease (GD) are rare. Here, we report a case of a 17-year-old patient with unilateral symptomatic middle cerebral artery stenosis concurrent with GD and myopathy. He presented with a 1-day history of acute severe right-sided hemiparesis and aphasia and a 3-week history of high metabolic syndrome. The pathogenesis of the stenosis is most likely vasculitis rather than atherosclerosis, based on contrast-enhanced high-resolution magnetic resonance imaging showing concentric wall enhancement. We suggest that lipid storage myopathy is secondary to GD, and it is likely mitochondrial dysfunction or immune dysfunction induced by GD responsible for the myopathy and that magnetic resonance spectroscopy (MRS) is capable of establishing the diagnosis of myopathy. Thus, MRS can be used for follow-up evaluations of the myopathy along with the pathology biopsy.
authors.affiliation: Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Yin
authors.affiliation: Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Jiajia
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Dongling
authors.initials: D
authors.lastname: Huang
authors.affiliation: Department of Radiology, First Affiliated Hospital, Jinan University, Guangzhou, China.
authors.forename: Changzheng
authors.initials: C
authors.lastname: Shi
authors.affiliation: Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Guan
authors.affiliation: Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China. Electronic address: pan1965suyue@126.com.
authors.forename: Suyue
authors.initials: S
authors.lastname: Pan
mesh_terms: D000293:Adolescent; D003251:Constriction, Pathologic / Q000150:complications / Q000473:pathology; D006111:Graves Disease / Q000150:complications / Q000473:pathology*; D006801:Humans; D020765:Intracranial Arterial Diseases / Q000150:complications / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D020768:Middle Cerebral Artery / Q000473:pathology*; D009135:Muscular Diseases / Q000150:complications / Q000473:pathology*
keywords: Adolescent; Graves disease; infarction; magnetic resonance imaging; middle cerebral artery; muscular diseases