Abstract
Giant cell arteritis is the most common systemic vasculitis of medium and great vessels in adults over 50 years of age. This involvement preferentially the branches of the carotid and vertebral arteries, but the axillary, femoral and iliac arteries have also been involved. The case of an adult patient who debuted with a transient ischemic accident clinic who associated manifestation of moderate persistent frontotemporal headache and the physical examination with prominent and painful temporal arteries is reported. No symptoms or signs of mandibular claudication or polymyalgia rheumatica are reported. The diagnosis of giant cell arteritis was confirmed by temporal artery biopsy and corticosteroid therapy was instituted early with a good response to treatment. Cerebrovascular ischemic events are a relatively rare presentation and have been classically described when symptoms of vasculitis have started, in this case they presented as the initial manifestation of the active period of the disease, which denotes a diagnostic challenge that is important to consider. to initiate therapeutic measures early and reduce associated potentially serious complications. Among these therapeutic measures, the use of biological agents such as Tocilizumab, which as adjuvant therapy reduces the risk of relapse and cumulative corticosteroid exposure compared to corticosteroid monotherapy in cases of giant cell arteritis with complications, should be highlighted.
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