Case report shows vessel wall imaging's diagnostic value in identifying giant cell arteritis in ischemic stroke patients, suggesting its importance in early detection.
We report a rare case of giant cell arteritis (GCA) initially presenting as ischemic stroke in the perforating branch territory. An 81-year-old woman presented with dysarthria and was diagnosed with a right midbrain and pontine infarction. Six months later, the patient developed recurrent dysarthria and left hemiparesis. Magnetic resonance imaging (MRI) revealed a new right lenticulostriate infarct, and MRA showed rapidly progressive intracranial stenosis. Vessel wall MRI demonstrated concentric enhancement in the intracranial and extracranial arteries. A temporal artery biopsy confirmed the presence of GCA. This case highlights the diagnostic value of vessel wall imaging for detecting intracranial involvement in GCA.
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Yamamoto et al. (2025) studied this question.
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