title: Intracranial and Extracranial Neurovascular Manifestations of Takayasu Arteritis.
abstract: Takayasu arteritis is a rare, large-vessel vasculitis that presents with symptoms related to end-organ ischemia. While the extracranial neurovascular manifestations of Takayasu arteritis are well-established, little is known regarding the intracranial manifestations. In this study, we characterize the intracranial and cervical neurovascular radiologic findings in patients with Takayasu arteritis.
  
  
  
  Patients with Takayasu arteritis who presented to our institution between 2001 and 2016 with intracranial and/or cervical vascular imaging were included in this study. Images were evaluated for the presence of vascular abnormalities, including intracranial or extracranial stenosis, vessel-wall thickening, dissection, subclavian steal, aneurysms, infarcts, and hemorrhages. Descriptive analyses are reported.
  
  
  
  Seventy-nine patients with Takayasu arteritis met the criteria for inclusion in this study. The most common presenting neurologic symptoms were headache (32.9%) and dizziness (15.2%). Intracranial and extracranial vascular imaging was performed in 84.8% and 89.9% of patients, respectively. Among patients with intracranial vascular imaging, 3 (3.9%) had intracranial aneurysms, 3 (3.9%) had acute large-vessel occlusion, 6 (7.6%) had intracranial vasculitis, and 1 (1.3%) had reversible cerebrovascular constriction syndrome. Among patients with cervical vascular imaging, 42 (53.1%) had some degree of narrowing of the common carotid artery and 18 (22.8%) had narrowing of the ICAs. Seventeen patients (23.6%) had subclavian steal.
  
  
  
  Intracranial vascular abnormalities in patients with Takayasu arteritis presenting with neurologic symptoms are not rare, with cerebral vasculitis seen in 7.8% of patients, and stroke secondary to large-vessel occlusion, in 3.9% of patients. Cervical vascular manifestations of Takayasu arteritis were present in most patients in our study.
authors.affiliation: From the Mayo Clinic School of Medicine (K.M.B.), Rochester, Minnesota.
authors.forename: K M
authors.identifier: 0000-0002-7042-4146
authors.initials: KM
authors.lastname: Bond
authors.affiliation: Departments of Neurology (D.N.).
authors.forename: D
authors.identifier: 0000-0002-2676-5779
authors.initials: D
authors.lastname: Nasr
authors.affiliation: Radiology (V.L., G.L., H.J.C., W.B.).
authors.forename: V
authors.identifier: 0000-0002-8713-8293
authors.initials: V
authors.lastname: Lehman
authors.affiliation: Radiology (V.L., G.L., H.J.C., W.B.).|Neurosurgery (G.L.), Mayo Clinic, Rochester, Minnesota.
authors.forename: G
authors.identifier: 0000-0003-1479-465X
authors.initials: G
authors.lastname: Lanzino
authors.affiliation: Radiology (V.L., G.L., H.J.C., W.B.).
authors.forename: H J
authors.identifier: 0000-0003-2590-3815
authors.initials: HJ
authors.lastname: Cloft
authors.affiliation: Radiology (V.L., G.L., H.J.C., W.B.) brinjikji.waleed@mayo.edu.
authors.forename: W
authors.identifier: 0000-0001-5271-5524
authors.initials: W
authors.lastname: Brinjikji
mesh_terms: D000328:Adult; D001808:Blood Vessels / Q000473:pathology*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging; D002544:Cerebral Infarction / Q000000981:diagnostic imaging; D003251:Constriction, Pathologic; D004244:Dizziness / Q000209:etiology; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009420:Nervous System / Q000473:pathology*; D013349:Subclavian Steal Syndrome / Q000000981:diagnostic imaging; D013625:Takayasu Arteritis / Q000150:complications* / Q000473:pathology; D020293:Vasculitis, Central Nervous System / Q000000981:diagnostic imaging; D055815:Young Adult