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Spontaneous non-aneurysmal subarachnoid hemorrhage in Takayasu arteritis: a case implicating hyperperfusion and cerebral dysautoregulation

Takayasu arteritis (TA) is a systemic chronic inflammatory large-vessel vasculitis that affects the aorta, its major branches, and the pulmonary arteries. In this report, we describe a case of a young female with TA presenting with spontaneous subarachnoid hemorrhage (SAH), an unusual manifestation...

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Autores principales: Joshi, Hena, Allen, Jason, Qiu, Deqiang, Wu, Junjie, Nahab, Fadi, Law, Karen, Hu, Ranliang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Institute of Radiology. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726185/
https://www.ncbi.nlm.nih.gov/pubmed/31501710
http://dx.doi.org/10.1259/bjrcr.20180113
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author Joshi, Hena
Allen, Jason
Qiu, Deqiang
Wu, Junjie
Nahab, Fadi
Law, Karen
Hu, Ranliang
author_facet Joshi, Hena
Allen, Jason
Qiu, Deqiang
Wu, Junjie
Nahab, Fadi
Law, Karen
Hu, Ranliang
author_sort Joshi, Hena
collection PubMed
description Takayasu arteritis (TA) is a systemic chronic inflammatory large-vessel vasculitis that affects the aorta, its major branches, and the pulmonary arteries. In this report, we describe a case of a young female with TA presenting with spontaneous subarachnoid hemorrhage (SAH), an unusual manifestation of the disease. Magnetic resonance angiography (MRA) of the head and neck demonstrates multifocal carotid and vertebral arterial stenoses, but no aneurysm or vascular malformation to account for SAH. A novel and unexpected finding in this case was increased cerebral perfusion in the right frontotemporal parenchyma and transient abnormally reduced augmentation of flow in response to the cerebral vasodilator acetazolamide. The etiology of SAH thus may be related to hyperperfusion and loss of cerebrovascular autoregulation leading to small vessel damage.
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spelling pubmed-67261852019-09-09 Spontaneous non-aneurysmal subarachnoid hemorrhage in Takayasu arteritis: a case implicating hyperperfusion and cerebral dysautoregulation Joshi, Hena Allen, Jason Qiu, Deqiang Wu, Junjie Nahab, Fadi Law, Karen Hu, Ranliang BJR Case Rep Case Report Takayasu arteritis (TA) is a systemic chronic inflammatory large-vessel vasculitis that affects the aorta, its major branches, and the pulmonary arteries. In this report, we describe a case of a young female with TA presenting with spontaneous subarachnoid hemorrhage (SAH), an unusual manifestation of the disease. Magnetic resonance angiography (MRA) of the head and neck demonstrates multifocal carotid and vertebral arterial stenoses, but no aneurysm or vascular malformation to account for SAH. A novel and unexpected finding in this case was increased cerebral perfusion in the right frontotemporal parenchyma and transient abnormally reduced augmentation of flow in response to the cerebral vasodilator acetazolamide. The etiology of SAH thus may be related to hyperperfusion and loss of cerebrovascular autoregulation leading to small vessel damage. The British Institute of Radiology. 2019-02-01 /pmc/articles/PMC6726185/ /pubmed/31501710 http://dx.doi.org/10.1259/bjrcr.20180113 Text en © 2019 The Authors. Published by the British Institute of Radiology This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
spellingShingle Case Report
Joshi, Hena
Allen, Jason
Qiu, Deqiang
Wu, Junjie
Nahab, Fadi
Law, Karen
Hu, Ranliang
Spontaneous non-aneurysmal subarachnoid hemorrhage in Takayasu arteritis: a case implicating hyperperfusion and cerebral dysautoregulation
title Spontaneous non-aneurysmal subarachnoid hemorrhage in Takayasu arteritis: a case implicating hyperperfusion and cerebral dysautoregulation
title_full Spontaneous non-aneurysmal subarachnoid hemorrhage in Takayasu arteritis: a case implicating hyperperfusion and cerebral dysautoregulation
title_fullStr Spontaneous non-aneurysmal subarachnoid hemorrhage in Takayasu arteritis: a case implicating hyperperfusion and cerebral dysautoregulation
title_full_unstemmed Spontaneous non-aneurysmal subarachnoid hemorrhage in Takayasu arteritis: a case implicating hyperperfusion and cerebral dysautoregulation
title_short Spontaneous non-aneurysmal subarachnoid hemorrhage in Takayasu arteritis: a case implicating hyperperfusion and cerebral dysautoregulation
title_sort spontaneous non-aneurysmal subarachnoid hemorrhage in takayasu arteritis: a case implicating hyperperfusion and cerebral dysautoregulation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726185/
https://www.ncbi.nlm.nih.gov/pubmed/31501710
http://dx.doi.org/10.1259/bjrcr.20180113
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