Giant Cell Arteritis in Association with Posterior Circulation Strokes: Report of Two Cases with Normal Erythrocyte Sedimentation Rate | Biomegrid

Stroke can be a serious, potentially fatal complication of giant cell arteritis (GCA). GCA and its relationship with ischemic stroke has been extensively studied and clinically investigated; however, a reliable biomarker or clinical manifestation has not yet been identified to detect those patients who are at increased risk of developing brain infarction. In this case series, GCA as the primary etiology of posterior circulation stroke is discussed in two patients with headache and stroke as initial presenting symptoms. Because of unremitting headache without a specific etiology recognized, GCA was considered. Both patients had temporal artery biopsy (TAB) proven GCA, despite normal erythrocyte sedimentation rate (ESR). We make the case to support obtaining TAB in populations at risk for GCA, regardless of inflammatory markers, if headache is a prominent presenting symptom at the time of stroke.