Sanchez George, Long Theresa M, Warner Judith E A, Chung Lee S, Quigley Edward Patrick, Digre Kathleen B, Seay Meagan D, Crum Alison V, Katz Bradley J
Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah Health, Salt Lake City, UT, USA.
Department of Neurology, University of Utah Health, Salt Lake City, UT, USA.
Am J Ophthalmol Case Rep. 2025 Jan 16;37:102260. doi: 10.1016/j.ajoc.2025.102260. eCollection 2025 Mar.
Giant cell arteritis can have protean manifestations, many of them non-specific. We describe a patient whose initial presentation was most consistent with brainstem stroke, but who was ultimately diagnosed with and treated for giant cell arteritis.
A 76-year-old woman presented with abrupt onset diplopia, headache, nausea and vomiting. On presentation to the emergency department, she was diagnosed with a brainstem stroke and treated with tissue plasminogen activator. When her symptoms did not remit, closer inspection of her imaging revealed enhancement within the orbits and enhancement of her superficial and posterior temporal arteries. These findings led to the consideration of giant cell arteritis. Her signs and symptoms resolved with steroid treatment and a temporal artery biopsy was positive.
This case highlights the emerging role of MRI and other imaging techniques in improving our ability to non-invasively diagnose giant cell arteritis.
巨细胞动脉炎可有多种表现，其中许多是非特异性的。我们描述了一名患者，其最初表现最符合脑干卒中，但最终被诊断为巨细胞动脉炎并接受了相应治疗。
一名76岁女性突然出现复视、头痛、恶心和呕吐。在急诊科就诊时，她被诊断为脑干卒中并接受了组织纤溶酶原激活剂治疗。当她的症状没有缓解时，对其影像学检查的进一步观察发现眼眶内有强化以及颞浅动脉和颞后动脉有强化。这些发现促使考虑巨细胞动脉炎。她的体征和症状经类固醇治疗后缓解，颞动脉活检呈阳性。
本病例突出了MRI和其他成像技术在提高我们无创诊断巨细胞动脉炎能力方面日益重要的作用。
