[Early-onset cerebral infarction with psoriasis vulgaris and thromboangiitis obliterans as an athterosclerotic risk factor: a case report].

Abstract

The patient is a 45-year-old male. He has psoriasis vulgaris and thromboangiitis obliterans (TAO) as a comorbidity and was transferred to our hospital with dysarthria and right hemiparesis. On arrival, he presented with right hemispatial neglect, hemiparesis, and sensory disturbance. Head MRI showed scattered infarctions at the left middle cerebral artery territory, and 3D TOF MRA showed left middle cerebral artery occlusion. We performed mechanical thrombectomy with effective recanalization despite remained residual stenosis. Dual antiplatelet therapy was initiated, and neurological findings gradually improved. No apparent embolic source was identified including antibodies for vasculitis. He was diagnosed with large artery atherosclerosis with psoriasis and TAO as a vascular risk factor. Psoriasis is known to cause atherosclerosis and inflammatory disease by increasing cardiovascular risk. Contrast-enhanced MRI after three months of treatment for psoriasis showed decreased contrast signal at the stenotic lesion.