title: Stroke as the First Clinical Manifestation of Takayasu's Arteritis.
abstract: Takayasu's arteritis is a chronic inflammatory disease, and neurological symptoms occur in 50% of cases, most commonly including headache, dizziness, visual disturbances, convulsive crisis, transient ischemic attack, stroke and posterior reversible encephalopathy syndrome. The aim of this study was to report the case of a young Brazilian female with a focal neurological deficit. She presented with asymmetry of brachial and radial pulses, aphasia, dysarthria and right hemiplegia. Stroke was investigated extensively in this young patient. Only nonspecific inflammatory markers such as velocity of hemosedimentation and C-reactive protein were elevated. During hospitalization, clinical treatment was performed with pulse therapy showing improvement in neurological recuperation on subsequent days. In the chronic phase, the patient was submitted to medicated angioplasty of the brachiocephalic trunk with paclitaxel, with significant improvement of the stenosis. At the 6-month follow-up, the neurological exam presented mild dysarthria, faciobrachial predominant disproportionate hemiparesis, an NIHSS score of 4 and a modified Rankin Scale score of 3 (moderate incapacity). In conclusion, Takayasu's arteritis must be recognized as a potential cause of ischemic stroke in young females.
authors.affiliation: Department of Neurology, University Estadual Paulista Júlio de Mesquita Filho, Botucatu, Brazil.
authors.forename: Vanessa Caldeira
authors.initials: VC
authors.lastname: Pereira
authors.affiliation: Department of Interventional Radiology, University Estadual Paulista Júlio de Mesquita Filho, Botucatu, Brazil.
authors.forename: Carlos Clayton Macedo
authors.initials: CC
authors.lastname: de Freitas
authors.affiliation: Department of Neurorehabilitation, University Estadual Paulista Júlio de Mesquita Filho, Botucatu, Brazil.
authors.forename: Gustavo José
authors.initials: GJ
authors.lastname: Luvizutto
authors.affiliation: Department of Interventional Radiology, University Estadual Paulista Júlio de Mesquita Filho, Botucatu, Brazil.
authors.forename: Marcone Lima
authors.initials: ML
authors.lastname: Sobreira
authors.affiliation: Department of Neurology, University Estadual Paulista Júlio de Mesquita Filho, Botucatu, Brazil.
authors.forename: Daniel Escobar Bueno
authors.initials: DE
authors.lastname: Peixoto
authors.affiliation: Department of Neurology, University Estadual Paulista Júlio de Mesquita Filho, Botucatu, Brazil.
authors.forename: Inaldo do Nascimento
authors.initials: Ido N
authors.lastname: Magalhães
authors.affiliation: Department of Neurology, University Estadual Paulista Júlio de Mesquita Filho, Botucatu, Brazil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Bazan
authors.affiliation: Department of Stroke Unit, Botucatu School of Medicine, University Estadual Paulista Júlio de Mesquita Filho, Botucatu, Brazil.
authors.forename: Gabriel Pereira
authors.initials: GP
authors.lastname: Braga
keywords: Ischemic stroke; Takayasu's arteritis; Vasculitis of the central nervous system