Posterior Circulation Infarctions as Initial Presentation of Giant Cell Arteritis

Posterior circulation stroke is a rare but well-defined complication of giant cell arteritis (GCA). Here, we present the case of a 77-year-old woman with scattered posterior circulation infarcts who was found to have elevated inflammatory markers and multifocal vertebral artery luminal irregularities on magnetic resonance angiography. Though suspicion for vasculitis was initially low, she was treated with empirical steroids until further work-up could be pursued. Subsequent temporal artery biopsy, performed after 7 weeks of prednisone treatment, revealed active transmural arteritis, consistent with GCA.