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Couture P, Chazal T, Rosso C, Haroche J, Léger A, Hervier B, Deltour S, Amoura Z, Cohen Aubart F. Cerebrovascular events in Takayasu arteritis: a multicenter case-controlled study. J Neurol 2018; 265:757-763. [PMID: 29392458 DOI: 10.1007/s00415-018-8744-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 11/26/2017] [Accepted: 01/09/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Takayasu arteritis (TA) is a giant cell arteritis usually affecting young women and characterized by inflammatory and ischemic signs of large vessel involvement, including extracranial cerebral arteries. The impact of stroke on TA prognosis has not been well evaluated. METHODS We performed a retrospective multicenter review of patients with definite TA who experienced at least one stroke and compared the findings to 17 matched patients with TA diagnosis without neurological involvement. RESULTS Seventeen patients (15 women, median age at stroke diagnosis 44 years) receiving a diagnosis of TA and stroke between 2002 and 2016 in our institution were included, from a cohort of 126 patients suffering from TA (13.5%). At diagnosis, patients from both groups had comparable cardiovascular risk factors. The first cerebrovascular event was ischemic stroke (n = 15) or transient ischemic attack (n = 2). In eight patients, stroke occurred after the TA diagnosis was made. In four patients, stroke occurred after carotid surgery. At the end of follow-up, 59% of patients had a neurological impairment, 35% had a recurrence of stroke, and 24% suffered from epilepsy. CONCLUSIONS Stroke is a major cause of disability in TA patients. Internal carotid surgery may be performed with caution because of the risk of stroke after the procedure.
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Affiliation(s)
- Priscille Couture
- Service de Médecine 2, Institut e3m, Centre National de Référence Maladies Systémiques Rares, Lupus systémique et Syndrome des Anticorps Antiphospholipides, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, 75013, Paris, France
| | - Thibaud Chazal
- Service de Médecine 2, Institut e3m, Centre National de Référence Maladies Systémiques Rares, Lupus systémique et Syndrome des Anticorps Antiphospholipides, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, 75013, Paris, France
| | - Charlotte Rosso
- Service de Neurologie vasculaire, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, 75013, Paris, France.,Sorbonne Université, Université Paris VI Pierre et Marie Curie, 75013, Paris, France
| | - Julien Haroche
- Service de Médecine 2, Institut e3m, Centre National de Référence Maladies Systémiques Rares, Lupus systémique et Syndrome des Anticorps Antiphospholipides, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, 75013, Paris, France.,Sorbonne Université, Université Paris VI Pierre et Marie Curie, 75013, Paris, France
| | - Anne Léger
- Service de Neurologie vasculaire, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, 75013, Paris, France
| | - Baptiste Hervier
- Département d'immunologie clinique, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, 75013, Paris, France
| | - Sandrine Deltour
- Service de Neurologie vasculaire, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, 75013, Paris, France
| | - Zahir Amoura
- Service de Médecine 2, Institut e3m, Centre National de Référence Maladies Systémiques Rares, Lupus systémique et Syndrome des Anticorps Antiphospholipides, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, 75013, Paris, France.,Sorbonne Université, Université Paris VI Pierre et Marie Curie, 75013, Paris, France
| | - Fleur Cohen Aubart
- Service de Médecine 2, Institut e3m, Centre National de Référence Maladies Systémiques Rares, Lupus systémique et Syndrome des Anticorps Antiphospholipides, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, 75013, Paris, France. .,Sorbonne Université, Université Paris VI Pierre et Marie Curie, 75013, Paris, France.
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