Online first

Acta Reumatológica Portuguesa - Online First: 2019-09-23
Imagens em reumatologia

Bilateral vertebral artery occlusion without stroke secondary to giant cell arteritis

Bajko Z, Filep R, Maier S, Motataianu A, Andone S, Balasa R


Ultrasound examination has become an important tool in the diagnosis of giant cell arteritis, revealing the suggestive hypoechoic arterial wall thickening (halo sign). Vertebral artery involvement is not unusual in giant cell arteritis, but bilateral vertebral artery occlusion secondary to this affection is a rare condition and only a few cases have been reported so far. We report a case of an 84-year-old male patient with anterior ischaemic optic neuropathy secondary to giant cell arteritis, with bilateral occlusion of the vertebral arteries manifested with nonspecific neurological signs, detected during the ultrasound scan of the cervical arteries. The rarity of this case lies in the reasonably good outcome at the three-month and six-month follow-up and the absence of temporal artery involvement, despite the severe vertebral artery affection with bilateral occlusion.