Del Canto A Adolfo, Montoya S Francisca, Marileo Z Roberto, Cartier R Luis
Departamento de Ciencias Neurológicas Oriente, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Unidad de Neurorradiología, Instituto de Neurocirugía Dr. Asenjo, Santiago, Chile.
Rev Med Chil. 2018 Nov;146(11):1356-1360. doi: 10.4067/S0034-98872018001101356.
Giant cell arteritis is the most common vasculitis in patients aged over 50 years. We report an 89-year-old woman with significant weight loss and persistent frontal-occipital headaches lasting two months. The neurological examination at admission identified a decrease in visual acuity of the left eye, paralysis of the third cranial nerve of the right eye and alterations of body motility without objective signs of damage of the motor or sensitive pathways. Magnetic resonance imaging showed changes of the temporal artery wall and in both vertebral arteries, as well as bilateral cerebellar and occipital ischemic lesions. The Doppler ultrasound of the temporal arteries was compatible with Giant cell arteritis. Treatment with steroids was started. While receiving oral prednisone, the patient suffered new infarcts of the posterior territory, documented with a CAT scan.
巨细胞动脉炎是50岁以上患者中最常见的血管炎。我们报告一例89岁女性，体重显著减轻，持续性额枕部头痛持续两个月。入院时的神经系统检查发现左眼视力下降、右眼动眼神经麻痹以及身体运动改变，但无运动或感觉通路受损的客观体征。磁共振成像显示颞动脉壁及双侧椎动脉有改变，以及双侧小脑和枕叶缺血性病变。颞动脉多普勒超声检查结果符合巨细胞动脉炎。开始使用类固醇治疗。在接受口服泼尼松治疗期间，患者出现后循环新的梗死灶，CT扫描证实了这一点。
