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Cerebrovascular Findings in Takayasu Disease
Author(s) -
Hoffmann Michael,
Corr Peter,
Robbs John
Publication year - 2000
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon200010284
Subject(s) - medicine , transcranial doppler , radiology , magnetic resonance imaging , neuroimaging , positron emission tomography , stroke (engine) , perfusion scanning , nuclear medicine , perfusion , engineering , mechanical engineering , psychiatry
The authors define the frequency, nature, and extent of cerebrovascular sequelae of Takayasu arteritis using functional imaging. Retrospective analysis of the cases derived from the Durban Stroke Data Bank (n = 11 00) and Durban Metropolitan Vascular Surgery Database (n = 5300) consisted of evaluation by contemporary neuroimaging modalities including single positron emission computed tomograpy (SPECT), magnetic resonance imaging (MRI) diffusion scanning, and transcranial Doppler (TCD). Of all the patients identified with Takayasu disease (n = 142), 29 (20%) patients were identified with a primarily cerebrovascular presentation. The recent advent of modern functional imaging techniques allowed only the 10 most recent patients with a cerebrovascular presentation to be evaluated. Of these 10, 8 (80%) had normal neurologic deficit scores (Canadian neurologic score) and 9 (90%) were not disabled as determined by handicap scores (Rankin). The anatomic brain scans (9 MRI, 1 CT) were normal in 5 patients (50%). In 7 patients, transcranial Doppler sonography revealed increased velocities mainly in the anterior circulation with turbulence that was not circumscribed. Single positron emission computed tomograpy scanning revealed areas of hypoperfusion, mostly multiple, in all of the 7 cases investigated. The cerebral perfusion index was determined in 7 patients, with a good prognosis in 2 patients and a moderate prognosis in 5. Cerebral effects of Takayasu disease are best monitored by a combination of clinical and functional imaging such as TCD and SPECT scanning.