title: [Brain stem infarction, temporal headache, and elevated inflammatory parameters in a 74-year-old man].
abstract: We report the case of a 74 year old man with a brain stem infarction, temporal headache and elevated inflammatory parameters. Giant cell arteritis with involvement of the temporal and vertebral arteries was proven by histology, duplex sonography and MRI. Although intensive immunosuppressive therapy was started, the patient developed two brain infarcts within 6 months. Initially, C‑reactive protein and erythrocyte sedimentation rate were significantly elevated, but normalized over time. Involvement of the vertebral artery in giant cell arteritis is thought to be rare; steroid refractory courses are very rare. Brain stem infarction might be the consequence.
authors.affiliation: Abteilung für Rheumatologie und Osteologie, Klinik Der Fürstenhof, Am Hylligen Born 7, 31812, Bad Pyrmont, Deutschland. gehlen@staatsbad-pyrmont.de.|Evangelisches Krankenhaus, Universität Oldenburg, Campus Medizin, Oldenburg, Deutschland. gehlen@staatsbad-pyrmont.de.
authors.forename: M
authors.initials: M
authors.lastname: Gehlen
authors.affiliation: Evangelisches Krankenhaus, Universität Oldenburg, Campus Medizin, Oldenburg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Schwarz-Eywill
authors.affiliation: Evangelisches Krankenhaus, Universität Oldenburg, Campus Medizin, Oldenburg, Deutschland.
authors.forename: N
authors.initials: N
authors.lastname: Schäfer
authors.affiliation: Evangelisches Krankenhaus, Universität Oldenburg, Campus Medizin, Oldenburg, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Pfeiffer
authors.affiliation: Evangelisches Krankenhaus, Universität Oldenburg, Campus Medizin, Oldenburg, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Bösenberg
authors.affiliation: Nordwestdeutsches Rheumazentrum, St.-Josef-Stift Sendenhorst, Sendenhorst, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Maier
authors.affiliation: Abteilung für Rheumatologie und Osteologie, Klinik Der Fürstenhof, Am Hylligen Born 7, 31812, Bad Pyrmont, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Hinz
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D020526:Brain Stem Infarctions / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control; D003937:Diagnosis, Differential; D004660:Encephalitis / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D013700:Giant Cell Arteritis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D020773:Headache Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D017211:Treatment Failure
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone
keywords: Duplex sonography; Medulla oblongata; Prednisolone; Steroid-refractory giant cell arteritis; Vertebral artery