Takayasu's arteritis (Fig. 7.5) is a primary arteritis of unknown cause but probably also related to T cellmediated inflammation. Takayasu's arteritis commonly affects large vessels including the aorta and its major branches to the arms and the head. It is more commonly seen in Asia and usually affects young women . Pulseless upper extremities and hypertension are the common clues to suggest the diagnosis. Most patients are treated with steroids alone to reduce the inflammation. The prognosis is relatively good and 90% of patients are still alive after 10 years. TIA or stroke is rare but can occasionally occur in severe cases with significant stenosis of arteries supplying the CNS (Fig. 7.5).
Figure 7.5 a-d
Takayasu's arteritis in an 18-year-old woman with left hemiparesis. a T2-weighted image shows a hyperintense lesion in the right basal ganglia and temporal lobe (arrows). b DW image shows a very high signal le-sion,indicating an acute infarct. c Tl-weighted axial image shows occlusion of internal carotid arteries bilaterally and the left vertebral artery, with thickening of the wall and thrombosis (arrows).d DSA shows occlusion of both carotid arteries, and stenosis of the brachio-cephalic and left subclavian arteries (arrows)
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