Recurrent cervicocephalic artery dissection in a patient with Churg-Strauss syndrome treated with long-term corticosteroid therapy

Abstract

Churg-Strauss syndrome (CSS) is known to mainly involve small vessels; thus, in the event of large-vessel disease, other causes must be taken into consideration. We report a case of CSS with recurrent arterial dissection of the cervicocephalic arteries. A 74-yearold man with CSS visited the emergency department because of sudden left hemiparesis. He had been taking corticosteroids as CSS treatment for 12 years. He had a confirmed right vertebral dissection 10 years before and a right distal internal carotid artery dissection 1 year before. As the arterial dissection occurred in the same vessel region a year before, a stent was deployed in the region. A large cervicocephalic artery dissection in patients with CSS that is well regulated with immunotherapy is likely caused by the long-term corticosteroid therapy weakening the vessel wall; therefore, replacement with the appropriate immunotherapy should be considered.