Abstract
Takayasu’s arteritis (TAK) is a large-vessel vasculitis that targets the aorta and its major branches. Although extracranial vascular involvement is uniformly present in this disease, the frequency of intracranial involvement in TAK has not been well studied. We retrospectively reviewed the clinical and imaging records of patients diagnosed with TAK at a single Canadian university medical centre to determine the prevalence of intracranial vascular involvement. Intracranial vascular and non-vascular findings were described, and a review of the literature was performed. Of 20 patients with TAK, 12 had vascular neuroimaging completed. Intracranial vascular lesions were identified in 4 patients (33.3% of those with imaging available, 20% of all patients). The frequency of intracranial vessel involvement in TAK may be more common than appreciated. Imaging of both the intra- and extra-cranial vessels should be considered in these young patients.
Highlights
Takayasu’s arteritis (TAK) is a large-vessel vasculitis of unknown etiology, which, by definition, affects younger persons, and results in aneurysms, stenoses, and occlusions of the aorta and its major branch vessels
A single neuroradiologist reviewed the images of available vascular neuroimaging (computerized tomography angiography (CTA), magnetic resonance angiography (MRA), conventional angiography) and non-vascular neuroimaging (CT, MR, positron emission tomography/computerized tomography (PET/CT)) studies and recorded the presence and characteristics of intracranial or extra-cranial head and neck lesions
All patients had a clinical diagnosis of TAK by their rheumatologist, and all had imaging evidence of large-vessel vasculitis involving the aorta and/or its major branches, as defined above
Summary
Takayasu’s arteritis (TAK) is a large-vessel vasculitis of unknown etiology, which, by definition, affects younger persons, and results in aneurysms, stenoses, and occlusions of the aorta and its major branch vessels. Existing literature suggests that intracranial vascular disease may affect between 5% and 50% of TAK patients [5,6,7,8,9,10,11,12]. This wide range is likely attributed to the differences in study designs, imaging modalities utilized, and the limited availability of neuroimaging studies among asymptomatic patients
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