Winiwarter-Buerger disease ('thromboangiitis obliterans') with cerebral involvement.

A patient with clinical and radiological manifestations o Winiwarter-Buerger disease ("thromboangiitis obliterans") in the extremities had three cerebrovascular events during a five-year follow-up. Changes of infarction were confirmed by computed tomographic brain scan and arteriography, but no clinical or laboratory evidence of vasculitis nor a source of recurrent emboli could be found. He had no atherosclerotic risk factors except being a heavy smoker. Cerebrovascular involvement in Buerger's disease is infrequent, but clinical and pathological demonstration has occasionally been found. The existence of Buerger's disease has been questioned, but there appears to be a distinct syndrome of vascular disease that is not atherosclerotic or vasculitic. Stroke maybe a component of this syndrome and may be a complication preventable by cessation of smoking.