Kong K K Y, Mackinnon A D, Bridges L R, Cloud G C
Acute and Stroke Medicine Specialty Registrar, Atkinson Morley Regional Neuroscience Centre, St Georges Hospital, Blackshaw Road, Tooting, London.
Consultant Neuroradiologist, Atkinson Morley Regional Neuroscience Centre, St Georges Hospital, Blackshaw Road, Tooting, London.
Acute Med. 2014;13(2):68-71.
An 80 year old man presented subacutely with drowsiness and confusion. Subsequent MRI brain imaging demonstrated multiple posterior circulation infarcts. Extracranial vasculitis was suspected when his ESR was found to be high and vascular imaging showed multifocal irregular narrowing of both vertebral arteries. This was confirmed by targeted temporal artery biopsy, which showed chronic granulomatous inflammation typical of giant cell arteritis (GCA). The patient made a significant recovery following treatment with prednisolone.
一名80岁男性以嗜睡和意识模糊的亚急性症状就诊。随后的脑部MRI成像显示有多处后循环梗死。当发现他的血沉(ESR)升高且血管成像显示双侧椎动脉多灶性不规则狭窄时,怀疑存在颅外血管炎。经靶向颞动脉活检证实了这一诊断,活检显示为典型的巨细胞动脉炎(GCA)的慢性肉芽肿性炎症。患者在接受泼尼松龙治疗后有显著恢复。