Wegener’s Granulomatosis and Vertebro-Basilar Thrombosis

High Risk of Pulmonary Embolism and Deep Venous Thrombosis but Not of Stroke in Granulomatosis With Polyangiitis (Wegener's)

“…Although GPA can involve the central nervous system (), the risk of stroke associated with the syndrome is not well characterized. Ischemic and hemorrhagic strokes have been described in patients with GPA (), and some cases of stroke have been histologically linked to cerebral vasculitis (). To our knowledge, however, the incidence of stroke among GPA patients has not been examined in epidemiologic studies.…”

Cardioembolic stroke secondary to non‐bacterial endocarditis in wegener disease

“…Central nervous system involvement is an uncommon complication [2]. Ischemic strokes have been described as hemorrhagic [3] and can affect any vascular territory [vertebrobasilar (4–6), anterior cerebral (7)] and such strokes may be the first manifestation of the disease [8]. Our patient fulfilled the diagnostic criteria for Wegener granulomatosis, [9] as he met more than the two of the required criteria: (i) nasal or oral inflammation, (ii) abnormal chest x‐ray with nodules, fixed infiltrates, or cavities, and (iii) granulomatous inflammation on biopsy of an artery or perivascular area (Table 1).…”

“…The vasculitis that appears in Wegener granulomatosis affects the small vessels and therefore, is missed in the MRI angiography. Other reported mechanisms include arterial dissection [11], thrombosis [12], intra‐arterial chemotherapy infusion [4,9] and lastly, endothelial dysfunction secondary to elevated proteinase‐3 levels [5]. Although the presence of non‐bacterial endocarditis has been described in patients with Wegener granulomatosis in isolated cases [13–17], there are no reports in which these lesions led to cardioembolic strokes.…”