Published: 2021-03-23

Unusual etiology of stroke in young adults: think of Takayasu’s arteritis

Vikram Aglave, Shashank Nagendra, Pawan T. Ojha, Kamlesh A. Jagiasi, Sumit Kharat, Prachi Barvalia, Abhijit Gaikwad


Takayasu arteritis is an uncommon inflammatory disease of vessels that preferentially affects the aorta and its major branches. It can be a potential cause of stroke in young adults. Current study included 7 patients aged between 18 to 48 years. Each patient had varying presentations of stroke with Takayasu’s arteritis along with other neurological symptoms. Four of the 7 patients presented with ischemic strokes, one with hemorrhagic stroke, one with TIAs and one with syncopal attacks. All the patients had elevated erythrocyte sedimentation rates. Five of the seven patients were treated with steroids and methotrexate. Two were treated with azathioprine and steroids. Antiplatelets were given for those patients who had strokes and TIAs. Our cases demonstrate that Takayasu arteritis can present with varying presentations including stroke. Thus, it is important to consider Takayasu’s arteritis as an unusual etiology of stroke especially in young adults.


Takayasu’s Arteritis, Stroke, Young stroke

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Zaldivar MLF, de la Rocha JAL, Espinoza LR. Takayasu arteritis: recent developments. Curr Rheumatol Rep. 2019;21(9):45.

Serra R, Butrico L, Fugetto F, Chibireva MD, Malva A, De Caridi G, et al. Updates in pathophysiology, diagnosis and management of takayasu arteritis. Ann Vasc Surg. 2016;35:210-25.

Harky A, Fok M, Balmforth D, Bashir M. Pathogenesis of large vessel vasculitis: implications for disease classification and future therapies. Vasc Med. 2019;24(1):79-88.

de Paula LE, Alverne AR, Shinjo SK. Clinical and vascular features of Takayasu arteritis at the time of ischemic stroke. Acta Reumatol Port. 2013;38:248-51.

Takayasu M. A case with peculiar changes of the retinal cerebral vessels. Acta Ophthal Soc. 1908;12: 554-5.

Hall S, Barr W, Lie JT, Stanson AW, Kazmier FJ, Hunder GG. Takayasu arteritis. A study of 32 North American patients. Medicine. 1985;64(2):89-99.

Sen PK. Nonspecific aorto/arteritis a monograph based on a study of 101 cases. India: Tata McGraw Hill; 1972.

Chhetri MK, Raychaudhari B, Neelkantan C, Basu J, Chaki S, Saha AK. A profile of non-specific arteritis as observed in Eastern India. J Assoc Phys Ind. 1974;22:839-47.

Sharma BK, Jain S. A possible role of sex in determining distribution of lesions in Takayasu Arteritis. Int J Cardiol. 1998;66(Suppl. 1):S81-4.

Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: a review. J Clin Pathol. 2002;55:481-6.

Maeda Y, Taguchi H, Kudo T, Okano Y. Takayasu arteritis and ischaemic stroke. QJM. 2016;109(1):45-6.

Pereira VC, de Freitas CC, Luvizutto GJ, Sobreira LM, Peixoto EB, Magalhães I dN, et al. Stroke as the first clinical manifestation of Takayasu's Arteritis. Case Rep Neurol. 2014;6:271-4.

Sikaroodi H, Motamedi M, Kahnooji H, Gholamrezanezhad A, Yousefi N. Stroke as the first manifestation of Takayasu arteritis. Acta Neurol Belg. 2007;107(1):18-21.

Arend WP, Michel BA, Bloch DA, Hunder GG, Calabrese LH, Edworthy SM, et al. The american college of rheumatology 1990 criteria for the classification of Takayasu’s arteritis. Arthritis Rheum. 1990;33:1129-34.

Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, et al. Takayasu arteritis. Ann Intern Med. 1994;120(11):919-29.

Ueda H, Morooka S, Ito I, Yamaguchi H, Takeda T, Saito Y. Clinical observation of 52 cases of aortitis syndrome. Jpn Heart J. 1969;10:277-88.

Liang P, Hoffman GS. Advances in the medical and surgical treatment of Takayasu arteritis. Curr Opin Rheumatol. 2005;17(1):16-24.

Subramanyan R, Joy J, Balakrishna KJ. Natural history of aortoarteritis. Circulation. 1989;80:429-37.

Motamedi M, Kahnooji H, Sikaroodi H, Gholamrezanezhad A, Yousefi N. Stroke as the first manifestation of Takayasu arteritis. Acta Neurol Belg. 2007;107(1):18-21.