Stroke as the Sole Manifestation of Takayasu Arteritis in a 15-Year-Old Boy with Latent Tuberculosis

Abstract

Introduction. Takayasu arteritis is a rare disease affecting the aorta and its main branches, causing arterial claudication and end-organ ischemia, including stroke. The etiology is unknown but is believed to be autoimmune. An association between Takayasu arteritis and tuberculosis has been suggested, but the possible relation is unclear. Case Presentation. A 15-year-old Somali boy was diagnosed with latent tuberculosis. He had a lesion in the right lung, and both the tuberculin skin test by the Mantoux method and Quantiferon GOLD test turned out positive. After he suffered a cerebral infarct in the right hemisphere, childhood Takayasu arteritis was diagnosed. The diagnosis was based on diagnostic imaging showing a high-grade stenosis of the origin of the right common carotid artery, an occluded common carotid artery on the left side, a circumferential thickening of the vessel walls in the right and left common carotid artery, and laboratory findings with elevated C-reactive protein. Conclusion. Takayasu arteritis is an uncommon cause of stroke. It should however be kept in mind as a cause of cerebrovascular disease, especially in the young.

The association between tinnitus and the risk of ischemic cerebrovascular disease in young and middle-aged patients: A secondary case-control analysis of a nationwide, population-based health claims database

“…Similarly, a study of 264 patients in Taiwan also reported that the four most common risk factors for young ischemic stroke were hyperlipidemia, smoking, hypertension, and a family history of stroke [ 20 ]. Other rarer causes of young stroke included severe iron-deficiency anemia with or without reactive thrombocytosis [ 18 ], Moyamoya syndrome [ 21 ], and Takayasu arteritis [ 22 ]. In addition, intracranial stenosis was reported to be more common than extracranial stenosis in both the carotid and vertebrobasilar systems of young ischemic stroke in Taiwan [ 20 ].…”

Takayasu Arteritis

“…Nearly 20% of patients evidence neurological involvement, which can be the presenting symptom at disease onset. The most common neurological symptoms are severe headaches; organic confusion, cognitive dysfunction, stroke, meningitis, encephalitis, and seizures (not related to hypertension) may also occur ( 81 , 82 ). Children with TA exhibit more frequent and heterogeneous neurological features than adults.…”

Takayasu Arteritis in Chronic Migraine

“…Almost 20% of patients with TA show neurological compromise. The most common neurological symptoms are severe headaches, organic confusion, cognitive dysfunction, prolonged amaurosis, stroke, meningitis, middle cerebral artery aneurysm, reversible encephalopathy, and seizures (unrelated to hypertension) [11].…”