Abstract
Giant Cell Arteritis in Association with Posterior Circulation Strokes: Report of Two Cases with Normal Erythrocyte Sedimentation Rate
Highlights
We describe two patients who presented with symptoms consistent with posterior circulation stroke and the prominent clinical feature of headache
Careful consideration of the diagnosis of Giant Cell Arteritis (GCA) should be given in the appropriate clinical context
Evidence to support obtaining inflammatory markers, such as erythrocyte sedimentation rate (ESR) and C-reactive protein, as part of the routine workup for patients presenting with transient ischemic attack (TIA) or stroke-like symptoms and headache is well known and accepted
Summary
We describe two patients who presented with symptoms consistent with posterior circulation stroke and the prominent clinical feature of headache. Neuroimaging confirmed ischemic infarction of the posterior circulation, as seen on diffusion-weighted sequences on magnetic resonance imaging (MRI). Both patients had normal ESR on presentation and were diagnosed with Giant Cell Arteritis (GCA) via temporal artery biopsy (TAB); both responded well to oral steroids with resolution of symptoms once treatment was initiated. Patient endorsed persistent pain over his left eye with associated frontal headache. He denied jaw claudication, scalp tenderness or myalgias
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