Inafuku T, Watanabe M, Takagi M, Hoshino H, Morinaga S, Koto A
Department of Neurology, Tokyo Saiseikai Central Hospital.
Rinsho Shinkeigaku. 1998 Apr;38(4):323-8.
Internal carotid artery involvement and dementia occur infrequently in patients with giant cell (temporal) arteritis. A 75-year-old woman admitted with progressive cognitive decline, drowsiness and headache was diagnosed as having giant cell arteritis by temporal artery biopsy (TAB). High dose corticosteroid improved inflammatory reaction but did not improve his cognitive function. Cerebral angiograms showed obstruction of both internal carotid arteries at the siphon. Brain MRI showed only small cerebral infarcts in the basal ganglia and corona radiata bilaterally. However, brain SPECT disclosed reduced cerebral blood flow in the frontal lobe bilaterally. A postmortem examination revealed bilateral parietal infarcts and isolated giant cell arteritis involving the both internal carotid arteries at the siphon. We speculated that perfusion insufficiency and multiple cerebral infarction due to bilateral internal carotid artery occlusion had caused this neurologic deterioration.
巨细胞（颞）动脉炎患者很少出现颈内动脉受累和痴呆。一名75岁女性因进行性认知功能减退、嗜睡和头痛入院，经颞动脉活检（TAB）诊断为巨细胞动脉炎。高剂量皮质类固醇改善了炎症反应，但未改善其认知功能。脑血管造影显示双侧颈内动脉虹吸段阻塞。脑部MRI仅显示双侧基底节和放射冠有小的脑梗死。然而，脑SPECT显示双侧额叶脑血流减少。尸检发现双侧顶叶梗死以及孤立的巨细胞动脉炎累及双侧颈内动脉虹吸段。我们推测双侧颈内动脉闭塞导致的灌注不足和多发性脑梗死引起了这种神经功能恶化。
