Giant Cell Arteritis - A Disease not to be Missed in Acute Ischemic Stroke

Abstract

Giant cell arteritis is described classically as a medium and large vessel inflammatory disease. It generally affects the external carotid vascular system and causes its typical symptoms. However, relatively uncommon is its involvement of internal carotid artery to cause visual disturbances and ischemic strokes. Typically, ultrasonography of the superficial temporal artery shows classical feature of the disease i.e., halo sign with a high sensitivity. Biopsy of the affected vessel, even though less sensitive, is diagnostic. We are describing such a case of giant cell arteritis involving both external and internal carotid vascular system which is negative on biopsy and did not show typical ultrasonographic features but diagnosed based on clinical criteria. Additionally the patient also had a severe atherosclerotic carotid vascular disease. Both of which may be associated with ischemic stroke.