From the Departments of *Neurology and †Pathology, Massachusetts General Hospital; and ‡Harvard Medical School, Boston, MA.
J Clin Rheumatol. 2013 Oct;19(7):393-6. doi: 10.1097/RHU.0b013e3182a6ffc1.
An 82-year-old woman presented with bilateral, symmetric posterior circulation infarctions secondary to giant cell arteritis (GCA). Her atypical clinical presentation included a lack of headache and fever, but she exhibited signs of systemic illness including generalized weakness, cachexia, apathy, and anemia. Laboratory testing revealed a markedly elevated erythrocyte sedimentation rate, but only a borderline elevated C-reactive protein. Head and neck vascular imaging demonstrated a pattern of vertebral arterial narrowing consistent with GCA-a diagnosis confirmed by temporal artery biopsy. Her unusual symptomatic, laboratory, and imaging presentation highlights the importance of considering GCA in the differential diagnosis of unusual bilateral stroke syndromes, where early treatment decreases morbid outcomes.
一位 82 岁女性因巨细胞动脉炎（GCA）出现双侧、对称的后循环梗死。她非典型的临床表现包括缺乏头痛和发热，但出现全身疾病的迹象，包括全身无力、恶病质、淡漠和贫血。实验室检查显示红细胞沉降率明显升高，但 C 反应蛋白仅轻度升高。头颈部血管成像显示符合 GCA 的椎动脉狭窄模式-经颞动脉活检证实的诊断。她不寻常的症状、实验室和影像学表现强调了在不常见的双侧脑卒中综合征的鉴别诊断中考虑 GCA 的重要性，早期治疗可降低不良结局的风险。
