Takayasu动脉炎(TAK)是一种病因不明的罕见大血管血管炎,可导致动脉壁增厚,狭窄,和遮挡,这可能使脑血管缺血事件复杂化。缺血性卒中是TAK年轻时的潜在毁灭性并发症,但这种情况在埃塞俄比亚仍然很少报道。虽然它发生在病情的后期,这可能是最初的表现,提示预后不良.在这里,我们处理了一个25岁的妇女,她在中风2年后随访期间到大学医院就诊,临床症状恶化,肱动脉搏动缺失,和双臂无法记录的血压。在2021年入院时,对比脑计算机断层扫描显示右侧大脑中动脉区域缺血性梗塞。然而,由于临床表现的模糊性和临床医生无法将TAK纳入鉴别诊断,当时无法确定中风的病因,导致病例的早期诊断延迟。两年后,2023年,她接受了计算机断层扫描血管造影,并根据美国风湿病学会的标准被诊断出患有TAK,NumanoIIb型血管造影疾病范围,缺血性卒中,和II期全身性高血压。该患者由专家治疗。该病例强调,在没有传统危险因素的情况下,年轻患者中风的鉴别诊断需要考虑TAK;应进行适当的检查以确认或排除这种诊断。和管理应该相应地修改。
Takayasu arteritis (TAK) is a
rare large-vessel vasculitis of unknown etiology that leads to arterial wall thickening, stenosis, and occlusion, which may complicate cerebrovascular ischemic events. Ischemic stroke is a potentially devastating complication of TAK at a young age, but the occurrence is still rarely reported in Ethiopia. Although it occurs late in the course of the condition, it may be the initial presentation and suggest an unfavorable prognosis. Herein, we address the
case of a 25-year-old woman who presented to a university hospital while on follow-up after 2 years of stroke with deterioration in clinical symptoms, absent brachial artery pulses, and unrecordable blood pressure in both arms. At the time of admission in 2021, the contrast brain computed tomography scan revealed an ischemic infarction in the right middle cerebral artery territory. However, the etiology of the stroke could not be defined at that time due to ambiguity in the clinical picture and the inability of clinicians to incorporate TAK into the differential diagnosis, resulting in a delay in the early diagnosis of the
case. Two years later, in 2023, she underwent computed tomography angiography and was diagnosed to have TAK based on American College of Rheumatology criteria, with Numano type IIb angiographic extent of disease, ischemic stroke, and stage II systemic hypertension. The patient was treated by a field of experts. This
case highlights the need to consider TAK in the differential diagnosis of stroke in young patients in the absence of traditional risk factors; appropriate tests should be performed to confirm or rule out this diagnosis, and management should be modified accordingly.