A case for cerebral thromboangiitis obliterans.

The existence of cerebral thromboangiitis obliterans (CTAO) has been controversial. The clinical, laboratory and angiographic features of a young woman with recurrent thrombophlebitis, digital gangrene and a bilateral anterior opercular syndrome (Foix-Chavany-Marie) are reported. The cerebral angiogram demonstrated significant narrowing of fronto-opercular branches of both middle cerebral arteries. Histology of small digital muscular arteries revealed segmental adventitial fibrosis, narrowing or occlusion of lumen and mild lymphocitic infiltrates; occasional veins showed phlebitis. An etiologic relationship between cerebral occlusive disease and peripheral thromboangitis obliterans (TAO) is suggested.