BACKGROUND: Takayasu's arteritis is a chronic inflammatory idiopathic disease involving large arteries like the aorta and its primary branches. Cell-mediated autoimmunity leading to vascular injury has been suspected in its pathogenesis although the antigen inducing the process remains unknown. CASE REPORT: A 50-year-old male patient suffered from acute hemiballism. Neuroimaging showed an infarction of right temporal insular cortex. Neurosonology and MR-Angiography revealed bilateral long-distant subtotal stenosis of the common carotid artery and left-sided occlusion of the subclavian artery. Positive hepatitis B serology with active viral replication was found. In the absence of other vasculitis or inflammation markers, Takayasu's arteritis was diagnosed and steroid therapy was started. CONCLUSIONS: Unilateral insular lesions may lead to transient hemiballistic movements which could be the result of decreased inhibitory output of the insula to basal ganglia. The hepatitis B virus possibly contains a surface antigen inducing a specific cellular immune response leading to Takayasu's arteritis.
BACKGROUND:Takayasu's arteritis is a chronic inflammatory idiopathic disease involving large arteries like the aorta and its primary branches. Cell-mediated autoimmunity leading to vascular injury has been suspected in its pathogenesis although the antigen inducing the process remains unknown. CASE REPORT: A 50-year-old male patient suffered from acute hemiballism. Neuroimaging showed an infarction of right temporal insular cortex. Neurosonology and MR-Angiography revealed bilateral long-distant subtotal stenosis of the common carotid artery and left-sided occlusion of the subclavian artery. Positive hepatitis B serology with active viral replication was found. In the absence of other vasculitis or inflammation markers, Takayasu's arteritis was diagnosed and steroid therapy was started. CONCLUSIONS: Unilateral insular lesions may lead to transient hemiballistic movements which could be the result of decreased inhibitory output of the insula to basal ganglia. The hepatitis B virus possibly contains a surface antigen inducing a specific cellular immune response leading to Takayasu's arteritis.
Authors: Vincenzo Di Stefano; Maria Vittoria De Angelis; Chiara Montemitro; Mirella Russo; Claudia Carrarini; Massimo di Giannantonio; Filippo Brighina; Marco Onofrj; David J Werring; Robert Simister Journal: Neurol Sci Date: 2021-02-11 Impact factor: 3.830
Authors: Josh Kahan; Laura Mancini; Maren Urner; Karl Friston; Marwan Hariz; Etienne Holl; Mark White; Diane Ruge; Marjan Jahanshahi; Tessel Boertien; Tarek Yousry; John S Thornton; Patricia Limousin; Ludvic Zrinzo; Tom Foltynie Journal: PLoS One Date: 2012-12-26 Impact factor: 3.240