Intracranial and extracranial neurovascular manifestations of takayasu arteritis

K. M. Bond, Deena Nasr, Vance T Lehman, G. Lanzino, H. J. Cloft, Waleed Brinjikji

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Original languageEnglish (US)
Pages (from-to)766-772
Number of pages7
JournalAmerican Journal of Neuroradiology
Volume38
Issue number4
DOIs
StatePublished - Apr 1 2017

Fingerprint

Takayasu Arteritis
Blood Vessels
Subclavian Steal Syndrome
Vasculitis
Neurologic Manifestations
Central Nervous System Vasculitis
Common Carotid Artery
Intracranial Aneurysm
Dizziness
Constriction
Aneurysm
Headache
Dissection
Pathologic Constriction
Ischemia
Stroke

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

Intracranial and extracranial neurovascular manifestations of takayasu arteritis. / Bond, K. M.; Nasr, Deena; Lehman, Vance T; Lanzino, G.; Cloft, H. J.; Brinjikji, Waleed.

In: American Journal of Neuroradiology, Vol. 38, No. 4, 01.04.2017, p. 766-772.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND AND PURPOSE: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.",
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AU - Brinjikji, Waleed

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