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Takayasu's arteritis is an idiopathic inflammatory disease of the large elastic arteries occurring in the young resulting in occlusive or ectatic changes mainly in the aorta and its immediate branches as well as the pulmonary artery and its branches. The disease is common in women in the second and third decades of life. Stroke as the first manifestation of Takayasu's disease is relatively rare. However 10–20% patients with Takayasu's arteritis can have a primary cerebrovascular presentation with headaches, seizures, transient ischemic attacks, strokes or intra-cerebral hemorrhage. We report a case of a 39-year-old lady who developed a stroke and was diagnosed as Takayasu's arteritis. This patient had fulfilled three of six criteria for Takayasu's arteritis based on The American College of Rheumatology. She responded to steroids and immune suppressive therapy.
Stroke as the first presentation of Takayasu's arteritis is relatively rare and only a few instances have been reported in the literature. Our patient had bilateral carotid occlusion and collaterals between the vertebral artery and external carotid arteries. She presented with right hemiplegia and after diagnosis she was promptly treated with prednisolone, methotrexate and other supportive measure. The patient had good clinical recovery.