HYBRID EVENT: You can participate in person at Orlando, USA or Virtually from your home or work.

6th Edition of International Conference on Neurology and Brain Disorders

October 24 -26, 2022

October 24 -26, 2022 | Orlando, Florida, USA
INBC 2022

Matineh Nirouei

Speaker at Neurology and Brain Disorders 2022 - Matineh Nirouei
Alborz University of Medical Sciences, Iran (Islamic Republic of)
Title : A case of internal carotid artery dissection in consequence of Giant cell arteritis

Abstract:

Giant cell arteritis (GCA) is a common and inflammatory condition that almost exclusively affect adults older than 50 years. GCA is a systemic vasculitis that involves medium-sized and larger arteries. GCA rarely can affect the brain-arteries, resulting in ischemic strokes and transient ischemic attacks.

We reported a 51-year- old man who presented in our clinic with sudden onset of right-side blurred vision, frozen movements, and ptosis in the right eye and left side paresis. His right pupil was not responding to the light, and the right eye's visual acuity was no light perception. Examination of ocular movements affirms a complete right ophthalmoplegia. Evaluation of the left eye was unremarkable. Spiral brain computed tomography (CT) scan and brain magnetic resonance imaging (MRI) showed multifocal diffusion restricting lesions involving all lobes of the right hemisphere and some involvements in the maxillary sinus that spread to the cavernous sinus. After this report, we promote a CT angiography that shows internal carotid artery dissection. Also, due to the history of ipsilateral frontotemporal headache and the high (ESR:90) level, we started pulse of Methylprednisolone 1 gram daily in suspicion of GCA, and temporal artery biopsy was done after 1 week, which was positive for GCA in pathology findings. After 10 days of administrating corticosteroid therapy, inflammatory markers were reduced (ESR:40). Besides improving headaches, there was no significant change in ptosis and ocular movements, visual acuity, and reduction of left limb's force.

Diagnosis of GCA is critical because delay can cause irreversible loss of vision in patients. Also, it can be challenging for those without the classic symptoms, such as headaches. The diagnosis of GCA with first manifestations of stroke and carotid dissection may be cause misdiagnosis.

What will audience learn from your presentation?

  • Giant cell arthritis is a systemic vasculitis. A 51-year-old man was presented with sudden onset of right-side blurred vision, frozen movements, and ptosis in the right eye and left side paresis. The diagnosis of GCA with first manifestations of stroke and carotid dissection may be neglected as an underlying cause.
  • When diagnosing stroke in elderly patients, based on the symptoms and paraclinical investigations, we should start treatment immediately before further diagnostic procedures if we suspect GCA and we have to have vasculitis in the further diagnosis.

 

Biography:

Dr. Matineh Nirouei studied Medicine at the Alborz University, Iran, and graduated with an MD degree in 2021. She is a highly motivated and innovative Doctor of Medicine. She is passionate about learning new scientific skills and also an enthusiastic team player adept at providing leadership while also learning from fellow team members. She has experience in managing multiple projects simultaneously. She is an effective communicator and presenter that can conceptualize complex and rare diseases to audiences with varied expertise. She has published about 10 research articles in different journals.

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