Stroke in GCA: One Cause, Two Manifestations?

January 14, 2015
Norman Bauman

An observational study of this rare comorbidity in a rare condition describes presenting symptoms and hints at a mechanism.

Larivière D, Sacre K, Klein I, et al.Extra- and Intracranial Cerebral Vasculitis in Giant Cell Arteritis: An Observational Study Medicine. 2014;93(28):e265 doi: 10.1097/MD.0000000000000265

Stroke that arises in patients with giant cell arteritis (GCA)  seems to be a distinct entity, according to these researchers.

A 6-year study of all 97 patients with GCA at the Bichat University Hospital in Paris found eight cases of stroke at diagnosis.  In these eight cases, the stroke followed the GCA.

The condition is associated with new headache and visual impairment in the setting of long-lasting cerebral angiitis.

Males predominate.

The patients in this review had frequent relapses and adverse effects from steroids. So immunosuppressive agents should be combined with steroids, the authors recommend.

The vascular lesions are in the bilateral vertebral and basilar arteries, and are distinct from the usual atherosclerotic lesions seen in stroke.

The authors conclude that the two conditions arise from a common mechanism, suggesting a link between vasculitis and ischemic brain lesions.