RARE CASE REPORT ON MULTIPLE CEREBRAL INFARCTS

Abstract

Background: Multiple This case report illustrates the diagnostic challenges and management strategies for Takayasu arteritis presenting with multiple cerebral infarcts.

Methods: A 54-year-old man with chronic headache, smoking, and progressive lower limb weakness was evaluated. The patient underwent MRI brain and MRA, revealing infarcts in the left posterior cerebral artery territory and distal left anterior cerebral artery territory.  The patient was treated with anticoagulants, low-dose steroids, and physical therapy.

Results: MRI and MRA revealed infarcts in the left PCA and distal ACA territories, with multiple gliotic changes in distal branches. Digital subtraction angiography (DSA) showed bilateral carotid stenosis, left vertebral artery occlusion, and 70% stenosis in the right vertebral artery. Initial management with subcutaneous heparin, oral anticoagulants, low-dose steroids, and physiotherapy resulted in significant improvement in mobility and reduction of headaches.

The patient refused stenting for carotid stenosis but continued to improve on oral anticoagulants and steroids.

Conclusion: This case highlights the importance of considering Takayasu muscular dystrophy in patients with unexplained multiple brain lesions and organ nerve deficiency. Early diagnosis and targeted therapy can lead to significant clinical improvement.