Case of Brain Biopsy Proven Giant Cell Arteritis

Ho Hyun Park; Seung Heon Kang; Sang Hoon Park; Jae-Sung Park; Bon San Koo

doi:10.4078/jrd.2016.23.6.396

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Park, Kang, Park, Park, and Koo: Case of Brain Biopsy Proven Giant Cell Arteritis

Case Report

J Rheum Dis 2016;23(6):396-400.

Published online: 31 October 2016

DOI: https://doi.org/10.4078/jrd.2016.23.6.396

Case of Brain Biopsy Proven Giant Cell Arteritis

Ho Hyun Park¹, Seung Heon Kang¹, Sang Hoon Park¹, Jae-Sung Park², Bon San Koo³

¹Department of Internal Medicine, Konkuk University College of Medicine, Chungju, Korea

²Department of Neurosurgery, Konkuk University College of Medicine, Chungju, Korea

³Division of Rheumatology, Department of Internal Medicine, Konkuk University College of Medicine, Chungju, Korea

Corresponding to: Bon San Koo, Division of Rheumatology, Department of Internal Medicine, Konkuk University College of Medicine, 268, Chungwon-daero, Chungju 27478, Korea. E-mail: koobonsan@gmail.com

Received 24 May 2016 Revised 21 July 2016 Revised 5 September 2016 Accepted 5 September 2016

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Giant cell arteritis (GCA) is categorized as vasculitis of the large and medium-sized vessels. Visual loss is one potential consequence of cranial arteritis. Temporal artery biopsies are performed frequently to demonstrate the involvement of arteritis. On the other hand, cerebral artery involvement with pathological findings is not well documented in patients with GCA. We report a rare case of GCA with cerebral vessel involvement in a 76-year-old woman.

Keywords: Giant cell arteritis, Cerebral artery, Vasculitis

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Figure 1.

Brain magnetic resonance T1-weighted contrastenhanced and T2-weighted images demonstrate a mass with vasogenic edema in the left frontal and temporal lobes. (A∼D) T2-weighted sequence images; (E∼H) T1-weighted contrastenhanced sequence images.

Figure 2.

Hematoxylin and eosin– stained sections demonstrating tissue necrosis and perivascular lymphocyte infiltration into the adjacent brain tissue (A, ×10) and artery with intimal thickening and multi-nucleated giant cell (arrow) (B, ×40).

Figure 3.

Computed tomography with angiography shows left temporal artery stenosis and occlusion (wide arrow) as well as left middle cerebral artery stenosis (narrow arrow).

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