1/17. Pathologic findings in a steroid-responsive optic nerve infarct in giant-cell arteritis.OBJECTIVE: To investigate the pathophysiologic mechanism of optic nerve infarction in giant-cell arteritis (GCA). BACKGROUND: Previous pathologic reports of optic nerve infarction in GCA involved patients who were blind at the time of death. The optic nerve infarcts were primarily retrolaminar in localization. Simultaneous short ciliary and ophthalmic artery vasculitis was found in all patients. methods: Clinical neurologic and ophthalmologic examination, temporal artery biopsy, and neuroimaging tests were performed in a patient with an anterior ischemic optic neuropathy secondary to GCA. Pathologic examination of the viscera, eye, and brain were performed at autopsy 1 month later. RESULTS: A prelaminar/retrolaminar infarct was found in this patient. Subsiding vasculitis was limited to the short ciliary arteries, sparing the central retinal, pial, and ophthalmic arteries. CONCLUSIONS: The authors believe that the visual improvement observed in this patient was the result of preserved, anterior optic nerve collateral circulation, as well as the neuroprotective and anti-inflammatory effect of the corticosteroids.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/17. Choroidal infarction, anterior ischemic optic neuropathy, and central retinal artery occlusion from polyarteritis nodosa.PURPOSE: Ocular ischemia from polyarteritis nodosa (PAN) is rare. The authors present a case of multifocal ocular infarction from PAN. methods AND RESULTS: A 70-year-old woman developed hand and foot numbness followed by intermittent blurred vision and binocular horizontal diplopia. Two weeks later, she suddenly lost vision in the right eye from a central retinal artery occlusion and then developed a left anterior ischemic optic neuropathy and bilateral triangular choroidal abnormalities consistent with infarction. Her erythrocyte sedimentation rate and c-reactive protein were elevated. Although giant cell arteritis was suspected, a multiple mononeuropathy was demonstrated by electromyogram and nerve conduction velocity studies. biopsy specimens from her sural nerve and biceps muscle showed a necrotizing vasculitis with fibrinoid necrosis, consistent with PAN. CONCLUSIONS: polyarteritis nodosa can produce ischemia of a variety of ocular structures, including the retina, choroid, and optic nerve. In our patient, all three structures were affected. To our knowledge, this is the first reported case of the triangular sign of Amalric in PAN.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
3/17. giant cell arteritis complicated by spinal cord infarction: a therapeutic dilemma.spinal cord involvement is uncommon in giant cell arteritis (GCA) and spinal cord infarction is extremely rare. We describe an 80-year-old man with active GCA who developed sudden paraplegia and dissociated sensory loss while receiving steroid treatment. magnetic resonance imaging showed high signal abnormality consistent with spinal cord infarction in the anterior spinal artery territory at the level of D10. The case illustrates the elusive nature of GCA and the diagnostic and therapeutic dilemmas faced by the physician caring for these patients.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
4/17. necrosis of the tongue in a patient with intestinal infarction.A patient with a rare combination of bilateral lingual necrosis and intestinal infarction, caused by giant cell arteritis, is described and the literature reviewed.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
5/17. Contemporaneous retinal and optic nerve infarcts, choroidal non-perfusion, and Hollenhorst plaque: are these all embolic events?A 76-year-old man developed a sudden painless superior field defect in the right eye, retinal whitening along the inferior temporal arcade, and fluorescein angiographic evidence of lobular choroidal non-perfusion. One week later, ophthalmoscopy revealed inferior optic nerve edema with splinter hemorrhages consistent with an anterior ischemic optic neuropathy (AION) and a new cholesterol plaque near the macula. There was no clinical, serologic, or pathologic evidence of giant cell arteritis. Carotid ultrasound revealed no evidence of significant stenosis but did show an echolucent soft plaque in the right carotid artery. Transthoracic echocardiography demonstrated normal left ventricular function with no source of emboli. The presumed cause of the clinical findings in this patient was embolism, a rarely reported cause of AION. An embolic origin may be considered in non-arteritic AION associated with choroidal non-perfusion.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
6/17. infarction of the small bowel caused by giant cell arteritis. Case report.A case with giant cell arteritis causing infarction of two segments of the small bowel is described in a 43-year-old woman. Subsequent angiography showed stenoses in both subclavian arteries and one common iliac artery, compatible with Takayasu's disease. The difficulties in distinguishing the different types of granulomatous giant cell arteries are discussed.- - - - - - - - - - ranking = 1.2keywords = giant (Clic here for more details about this article) |
7/17. giant cell arteritis with spinal cord infarction and basilar artery thrombosis.A patient with active giant cell arteritis developed paraparesis and dissociated sensory loss due to infarction in the anterior spinal artery territory at the level of T12. Three days later fatal basilar artery thrombosis occurred. No occlusive lesion was found to explain the anterior spinal artery syndrome but this was associated with active arteritis. Alternative possibilities are that thrombus was present in involved cervical feeding vessels, or that emboli arose from intimal involvement in larger vessels, or that the event was related to thrombocytosis.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
8/17. Lingual infarction and sudden blindness due to giant cell arteritis.A 72-year-old woman suffered from giant cell arteritis (GCA) which developed into lingual infarction and monocular blindness. Temporary obscuration of vision and lingual symptoms such as increasing malaise, pain and intermittent claudication may precede the catastrophic results of arteritis. Emphasis is laid on early recognition and treatment of GCA.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/17. Lingual infarction in giant cell arteritis. A case report.giant cell arteritis is a disease of the elderly, affecting the temporal or other cranial arteries, often in patients with polymyalgia rheumatica. A case of giant cell arteritis with necrosis of the tongue in a 77-year-old woman is reported. It is important to be aware of this condition because of the serious complications. As the lesion is focally distributed, it is necessary to obtain a large biopsy specimen from the superficial temporal artery in order to make a correct diagnosis. Prompt treatment with corticosteroid in large doses followed by a lower maintenance dose is important to prevent vascular complications.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/17. giant cell arteritis with small bowel infarction. A case report and review of the literature.This case report documents gangrene of the small intestine caused by giant cell arteritis of the regional mesenteric arteries, as an uncommon presentation of generalized giant cell arteritis. The literature concerning similar cases and the etiology is discussed.- - - - - - - - - - ranking = 0.4keywords = giant (Clic here for more details about this article) |
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