Takayasu Arteritis in a Patient Presenting with Stroke and Improvement of Hemiparesis Following Vascular Bypass Surgery: A Case Report

Takayasu arteritis (TA) is a rare disease, with an estimated incidence in general population of <1/year/million, and its presentation as a stroke is an even less common occurrence. The case presented herein is unusual for the fact that the surgical procedure was performed on an urgent basis, irrespective of the active or inactive status of the disease; the bypass technique involved multiple sites; the patient was administered an original combination of medications before and after the procedure, and the patient exhibited significant neurological improvement after the subacute period of the stroke (6 weeks after stroke, 1 week after the procedure), which was sustained at the 18-month follow-up. Published literature on bypass surgery for TA indicate that the majority of complications (aneurysms, stenosis, intracerebral hemorrhage, etc.) occur during the early stages and affect approximately one-third of patients; this procedure was also successful as the patient subsequently began recovering motor function, indicating the successful, sustained re-vascularization of the affected motor areas. Being able to restore the patient's independent activities of daily living is an important goal, which was achieved in this patient and may serve as a reference point for what is possible to achieve in these cases.