Ringleb P A, Strittmatter E I, Loewer M, Hartmann M, Fiebach J B, Lichy C, Weber R, Jacobi C, Amendt K, Schwaninger M
Department of Neurology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Rheumatology (Oxford). 2005 Aug;44(8):1012-5. doi: 10.1093/rheumatology/keh664. Epub 2005 Apr 19.
Takayasu arteritis is well known as a cause of stroke in Asia but has rarely been described in the Western world. Here we report the clinical and neuroimaging follow-up of a series of patients with Takayasu arteritis from Europe.
Seventeen consecutive patients who fulfilled the diagnostic criteria for Takayasu arteritis of the American College of Rheumatology were evaluated on follow-up by standardized neurological examination, sonography and MRI.
At follow-up almost 20 yr after onset of symptoms, the subclavian artery and the common carotid artery were often affected. In addition, evidence of intracranial pathology was found in seven patients. In contrast to the severe vessel involvement, the neurological state was stable. Two patients had suffered from stroke before the diagnosis was made and therapy was initiated, and one patient had recurrent transient ischaemic attacks. Intermittent dizziness was associated with pathology of the vertebral and basilar arteries. However, clinical symptoms of subclavian steal syndrome were rare.
This case series shows that the clinical neurological course of Takayasu arteritis on treatment is benign in most cases despite the severe vascular involvement.
大动脉炎在亚洲是导致中风的常见病因，但在西方世界鲜有报道。在此，我们报告一系列来自欧洲的大动脉炎患者的临床及神经影像学随访情况。
对连续17例符合美国风湿病学会大动脉炎诊断标准的患者进行随访，采用标准化神经检查、超声检查及磁共振成像（MRI）。
在症状出现后近20年的随访中，锁骨下动脉和颈总动脉常受累。此外，7例患者发现颅内病变证据。与严重的血管受累情况相反，神经状态稳定。2例患者在确诊并开始治疗前曾发生中风，1例患者有复发性短暂性脑缺血发作。间歇性头晕与椎动脉和基底动脉病变有关。然而，锁骨下动脉窃血综合征的临床症状罕见。
该病例系列表明，尽管血管受累严重，但多数接受治疗的大动脉炎患者临床神经病程呈良性。
