Takayasu's arteritis is a chronic inflammatory disease, and neurological symptoms occur in 50% of cases, most commonly including
headache,
dizziness, visual disturbances, convulsive crisis,
transient ischemic attack,
stroke and
posterior reversible encephalopathy syndrome. The aim of this study was to report the case of a young Brazilian female with a focal neurological deficit. She presented with asymmetry of brachial and radial pulses,
aphasia,
dysarthria and right
hemiplegia.
Stroke was investigated extensively in this young patient. Only nonspecific inflammatory markers such as velocity of hemosedimentation and
C-reactive protein were elevated. During hospitalization, clinical treatment was performed with pulse
therapy showing improvement in neurological recuperation on subsequent days. In the chronic phase, the patient was submitted to medicated angioplasty of the brachiocephalic trunk with
paclitaxel, with significant improvement of the
stenosis. At the 6-month follow-up, the neurological exam presented mild
dysarthria, faciobrachial predominant disproportionate
hemiparesis, an NIHSS score of 4 and a modified Rankin Scale score of 3 (moderate incapacity). In conclusion,
Takayasu's arteritis must be recognized as a potential cause of
ischemic stroke in young females.