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We report 3 patients with autopsy-proven (2 patients) or clinically diagnosed (1 patient) GCA causing BVAO. A review of the literature concerning BVAO revealed 5 other cases of BVAO resulting from GCA and 110 cases with underlying arteriosc lerotic disease. Although BVAO due to GCA is rare, physicians and especially rheumatologists or neurologist should be aware of this entity because of its high mortality in patients without immediate introduction of a high-dose immunosuppressive therapy. Suspicion of GCA should arise in a patient aged over 50 years with no other vascular risk factors suffering from bilateral symptoms of ischemia in the vertebrobasilar territory, with a quickly progressing stepwise course and with headache, fever, or hist ory of myalgia. ESR and temporal artery biopsy should be performed without delay. Early diagnosis of GCA is necessary for immediate initiation of intensive anti-inflammatory and immunosuppressive treatment, without which progressive deterioration and sy stemic involvement are likely to be fatal. |
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arteritis,temporal cerebrovascular accident cerebrovascular accident,acute management of cerebrovascular accident,bilateral fever headache headache,severe immunosuppressive agents mortality neuropathology prognosis review article sedimentation rate,elevated steroid therapy,CNS treatment and complications with treatment of neurologic disorder vertebral artery disease vertebral artery occlusion vertebral artery occlusion,bilateral vertebral-basilar insufficiency
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