BACKGROUND: Cerebral symptoms in temporal arteritis (TA) may occur if large arteries are affected. To avoid progression of the disease, the immediate administration of adequate doses of steroids is mandatory. PURPOSE: The prevalence and severity of vertebrobasilar ischemia (VBI) and its relation to structural abnormalities of the vertebral arteries were studied. METHODS: Clinical and ultrasound data were analyzed in a hospital-based group of 91 patients who received the diagnosis of TA following standard criteria. RESULTS: In contrast to the occurrence of neuro-ophthalmological complications (27.5%), the rate of VBI was low (4.4%). TIA occurred in three cases and mild stroke in one. Ultrasound demonstrated severe occlusive disease of the extradural parts of the vertebrobasilar arteries consisting of hypoechogenic, concentric, mural thickening. The same was found in the superficial temporal arteries. CONCLUSIONS: In elderly patients presenting with VBI, TA affecting the vertebral arteries should be considered. In experienced hands, ultrasonography allows the atraumatic preliminary diagnosis of TA.
BACKGROUND: Cerebral symptoms in temporal arteritis (TA) may occur if large arteries are affected. To avoid progression of the disease, the immediate administration of adequate doses of steroids is mandatory. PURPOSE: The prevalence and severity of vertebrobasilar ischemia (VBI) and its relation to structural abnormalities of the vertebral arteries were studied. METHODS: Clinical and ultrasound data were analyzed in a hospital-based group of 91 patients who received the diagnosis of TA following standard criteria. RESULTS: In contrast to the occurrence of neuro-ophthalmological complications (27.5%), the rate of VBI was low (4.4%). TIA occurred in three cases and mild stroke in one. Ultrasound demonstrated severe occlusive disease of the extradural parts of the vertebrobasilar arteries consisting of hypoechogenic, concentric, mural thickening. The same was found in the superficial temporal arteries. CONCLUSIONS: In elderly patients presenting with VBI, TA affecting the vertebral arteries should be considered. In experienced hands, ultrasonography allows the atraumatic preliminary diagnosis of TA.
Authors: G G Hunder; D A Bloch; B A Michel; M B Stevens; W P Arend; L H Calabrese; S M Edworthy; A S Fauci; R Y Leavitt; J T Lie Journal: Arthritis Rheum Date: 1990-08