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Multiple strokes after initiation of steroid therapy in giant cell arteritis.
  1. J. Collazos,
  2. C. García-Moncó,
  3. A. Martín,
  4. J. Rodriguez,
  5. M. A. Gómez
  1. Section of Internal Medicine, Hospital de Galdácano, Vizcaya, Spain.


    We report the case of a 66 year old woman with clinical manifestations of giant-cell arteritis, positive temporal artery biopsy and excellent response to prednisone, who developed massive cerebral infarcts after 5 days of treatment. Computed tomographic and magnetic resonance imaging scans revealed multiple infarcts in areas irrigated by both the carotid and vertebrobasilar systems bilaterally. A four-vessel angiography performed 19 days later revealed only mild atheromatous disease. Anticardiolipin antibodies were negative and a transoesophageal echocardiogram was normal. Stroke during the first 2 weeks of therapy in giant-cell arteritis, especially in the vertebrobasilar territory, has been previously reported. Anticoagulation during the first weeks of steroid treatment in these patients might be advisable.

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