Giant cell arteritis is a systemic inflammatory vasculitis, typically involving the superficial temporal arteries, but with possible ischemic and hemorrhagic cerebrovascular complications.
The case is reported of a patient with a clinical picture of giant cell arteritis, who had multiple occupational exposures to various infectious agents.
His initial favourable progress was followed by an atypical outcome. Despite immunosuppressive treatment, he developed fatal subarachnoid and intracerebral haemorrhages, possibly due to rupture of a microaneurysm of the posterior cerebral artery.
1. Csépány T, Illés Zs: Giant cell arteritis. Clinical neuroimmunology, 2nd edition. Budapest: Medical Tribune Scientific Devizió. 2014, pp. 133-143.
2. Calvo-Romero J. Giant cell arteritis. Postgrad Med J. 2003;79:511–515.
3. Calabrese LH, Duna GF, Lie JT. Vasculitis in the central nervous system. Arthritis Rheum. 1997;40(7):1189-1201.
4. Carlo S, Caterina G, Dylan V, Gene H. Giant Cell Arteritis: Involvement of intracranial arteries. Arthritis Rheum. 2006;55(6):985-9.
5. Kumar R, Wijdicks E F, Brown R D Jr, Parisi J E, Hammnod C A. Isolated angiitis of the CNS presenting as subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry. 1997;62(6): 649–651.
6. Salvarani C, Brown RD Jr, Calamia KT et al. Primary central nervous system vasculitis presenting with intracranial haemorrhage. Arthritis Rheum. 2011;63(11):3598-606.
7. Thal DR, Barduzal S, Franz K, Hermann G, Bode F, Lambrecht E, Schlote W. Giant cell arteritis in a 19-year-old woman associated with vertebral artery aneurysm and subarachnoid haemorrhage. Clin Neuropathol. 2001;20(2):80-86.
8. Love S, Renowden S, Carter M. Ruptured vertebrobasilar aneurysm associated with giant cell arteritis in a young boy. Clin Neurol Neurosurg. 2008;110(1):92-96.
9. Säve-Söderbergh J, Malmvall BE, Andersson R, Bengt-Ake B. Giant Cell Arteritis as a cause of death, Report of nine cases. JAMA. 1986;255(4):493-496.
10. Staunton H, Stafford F, Leader M, O’Riordarin et al. Deterioration of giant cell arteritis with corticosteroid therapy. Arch Neurol. 2000;57(4):581-584.