Ischemic stroke in a young adult male as a manifestation of Takayasu’s arteritis

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Published: 2008-03-25
DOI: https://doi.org/10.18051/UnivMed.2008.v27.39-50
Keywords:
Ischemic stroke, young adults, Takayasu’s arteritis, renovascular hypertension

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Riani Indiyarti
Neurology Department Medical Faculty Trisakti University

Abstract

Takayasu arteritis is a chronic, inflammatory large vessel arteriopathy that primarily affects the aorta, its main branches, and the pulmonary arteries. Fibrosis and thickening of the arterial wall often occur in later stages, resulting in a cerebrovascular accident. A 20-year old man presented with ischemic stroke of young adults due to Takayasu’s arteritis, from which he had been suffering since childhood (age 10). Physical examination showed an abdominal aortic aneurysm, renal artery stenosis, leading to renovascular hypertension, and asymmetrical blood pressure. Aneurysm of abdominal aorta was diagnosed by panaorto-arteriography. Subsequently ischemic stroke of young adults developed, because the arteritis had led to stenosis of the left anterior and middle cerebral arteries, with renovascular hypertension as additional risk factor. On this patient a percutaneous transluminal angioplasty operation of the right renal artery was performed, and it is intended to do an extra-intracranial arterial bypass. Preventive treatment is necessary to stem the extension of the arteritis to other blood vessels.

Article Details

Issue

Vol. 27 No. 1 (2008)

Section

Review Article

The journal allows the authors to hold the copyright without restrictions and allow the authors to retain publishing rights without restrictions.

How to Cite

Ischemic stroke in a young adult male as a manifestation of Takayasu’s arteritis. (2008). Universa Medicina, 27(1), 39-50. https://doi.org/10.18051/UnivMed.2008.v27.39-50

References

Stroke Mengancam Usia Produktif. Available at: http://www.medicastore.com/stroke. Accessed October 4, 2007.

Verona JF, Guerra JM, Bermejo F, Molina JA, Gomez A. Causes of ischemic stroke in young adults, and evolution of the etiological diagnosis over the long term. Europ Neurol 2007; 57: 212-8.

Lipska K, Sylaja PN, Sarma PS, Thankappan KR, Kutty VR, Vasan RS, et al. Risk factors for acute ischaemic stroke in young adults in South India. J Neurol, Neurosurg Psychiatry 2007: 78: 959-63.

Lee TH, Hsu WC, Chen CJ, Chen ST. Etiologic Study of Young Ischemic Stroke in Taiwan. Stroke 2002: 33: 1950.

Nomano F, Okawara M, Inomata H, Kobayashi Y. Takayasu’s arteritis. Lancet 2000; 356: 1023-5.

Ahmed W, Ahmad Z. Takayasu’s arteritis: a case report with global arterial involvement. Rawal Med J 2005: 30:

Brey RL, Moore M. Infammatory arteritis and stroke. In: Batjer HH, Caplan LR, Friberg L, Greenlee RG, Kopitnik TA, Young WL. Cerebrovascular disease. Lippincott-Raven. 1997: 506.

Adam RD, Victor M, Ropper AH. Principles of Neurology. 7th ed. New York: Mc Graw-Hill; 2001.

Ringleb PA, Strittmatter EI, Loewer M, Hartmann M, Fiebach JB, Lichy C, et al. Cerebrovascular manifestations of Takayasu’s arteritis in Europe. Rheumatology 2005; 44: 1012-5.

Cantú C, Pineda C, Barinagarrementeria F, Salgado P, Gurza A, de Pablo P, et al. Non-invasive cerebrovascular assessment of Takayasu’s arteritis. Stroke 2000; 31: 2197-202.

Krishna MV, Rudresh, Namratha S. Takayasu’s arteritis - stroke as an initial presentation. J Indian Acad Clin Med 2004; 5: 274-6.

Harris NL, McNeely WF, Shephard JO, Ebeling SH, Ellender SM, Peters CC. Case records of the Massachusetts General Hospital. N Engl J Med 2002; 347: 2057-65.

Kim DS, Kim JK, YooDs, Huh PW, Cho KS, Kang JK. Takayasu’s arteritis presented with subarachnoid hemorrhage: report of two cases. J Korean Med Sci 2002; 17: 695-8.

Renovascular hypertension. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000204.htm. Accessed October 3, 2007.

Renovascular hypertension. Available at: http://www.merck.com/mmpe/sec07/ch071/ch071b. html. Accessed Oktober 4, 2007.

Renovascular hypertension: What is it ? Available at: http://www.vdf.org/diseaseinfo/ras/. Accessed Oktober 4, 2007.

Ishikawa K. Diagnosis approach and proposed criteria for the clinical diagnosis of Takayasu’s arteriopathy. J Am Coll Cardiol 1988; 12: 964-72.

Arend WP, Michell BA, Bloch DA. The American College of Rheumatology 1990 criteria for the classification of Takayasu’s arteritis. Arthritis Rheum 1990; 33: 1129-34.

Neidhart B, Kosek R, BachmannL, Stey C. Exertional dyspnea as initial manifestation of Takayasu’s arteritis - a case report and literature review. BMC Pulmonary Medicine. Available at: http://www.biomedcentral.com/1471-2466/1/3. Accessed December 30, 2007.

Pinheiro LW, LeBlang SD, Romano J, Corteza A. The acute diagnosis of Takayasu’s arteritis based on helical CT angiography of the chest and neck in the emergency room. AJNR Am J Neuroradiol 1999; 20: 1983-5.