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• Vol.53 No.6
• CLINICA NEUROL, 53: 452−457, 2013
• Vol.53 No.6 contents

Case Report

A case of polyarteritis nodosa with giant intracranial aneurysm

Jyunichi Uemura, M.D.¹⁾, Takeshi Inoue, M.D.¹⁾, Junya Aoki, M.D.¹⁾, Naoki Saji, M.D.¹⁾, Kensaku Shibazaki, M.D.¹⁾ and Kazumi Kimura, M.D.¹⁾

¹⁾Stroke Medicine, Kawasaki Medical School

A 46-year-old man with a history of the left retinal central artery obstruction and old cerebral infarction in the right middle cerebral artery region presented with right total blindness due to the right retinal central artery occlusion accompanied by a cherry red spot. He had been found to have a giant, 17 mm-in-diameter aneurysm of the right internal carotid artery and a right vertebral arterial aneurysm. The intra-arterial thrombolysis was performed with urokinase injection for the right eye artery origin, and the right eyesight has improved. Cranial and pelvic angiography showed multiple stenosis and dilatation of external carotid and internal iliac arteries. The right superficial temporal artery biopsy revealed the arteritis with fibrinoid necrosis. He was diagnosed as having polyarteritis nodosa (PAN) by clinical course, angiography, and the superficial temporal artery biopsy. Several studies have reported that PAN had less intracranial aneurysm and the diameter of the aneurysm was less than 5 mm. Our case is the first report that PAN had giant aneurysm of 17 mm, diagnosed by temporal artery biopsy. The temporal artery biopsy should be considered to diagnose PAN.
Full Text of this Article in Japanese PDF (10415K)

(CLINICA NEUROL, 53: 452−457, 2013)
key words: polyarteritis nodosa, giant intracranial aneurysm, temporal artery biopsy

(Received: 23-Oct-12)