J Clin Neurol.  2012 Jun;8(2):109-115.

Ischemic Stroke in Takayasu's Arteritis: Lesion Patterns and Possible Mechanisms

Affiliations
  • 1Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kimgm@skku.edu
  • 2Department of Cardiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

BACKGROUND AND PURPOSE
The purpose of the present study was to use brain magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) to identify the mechanism of stroke in patients with Takayasu's arteritis (TA).
METHODS
Among a retrospective cohort of 190 TA patients, 21 (3 males and 18 females) with a mean age of 39.9 years (range 15-68 years) who had acute cerebral infarctions were included in lesion pattern analyses. The patients' characteristics were reviewed, and infarction patterns and the degree of cerebral artery stenosis were evaluated. Ischemic lesions were categorized into five subgroups: cortical border-zone, internal border-zone, large lobar, large deep, and small subcortical infarctions.
RESULTS
In total, 21 ischemic stroke events with relevant ischemic lesions on MRI were observed. The frequencies of the lesion types were as follows: large lobar (n=7, 33.3%), cortical border zone (n=6, 28.6%), internal border zone (n=1, 4.8%), small cortical (n=0, 0%), and large deep (n=7, 33.3%). MRA revealed that 11 patients had intracranial artery stenosis.
CONCLUSIONS
Hemodynamic compromise in large-artery stenosis and thromboembolic mechanisms play significant roles in ischemic stroke associated with TA.

Keyword

vasculitis; thromboembolism; intracranial artery stenosis

MeSH Terms

Arteries
Brain
Cerebral Arteries
Cerebral Infarction
Cohort Studies
Constriction, Pathologic
Hemodynamics
Humans
Infarction
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Male
Retrospective Studies
Stroke
Takayasu Arteritis
Thromboembolism
Vasculitis

Figure

  • Fig. 1 Comparison of stroke patterns in Takayasu's arteritis. BDZ: border zone infarction.

  • Fig. 2 Magnetic resonance angiography findings of intracranial artery stenosis in patients with Takayasu's arteritis. Arrows indicate the site of intracranial artery stenosis.


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