Abstrait

Unusual presentation of Takayasu Arteritis as a Non-Aneurysmal bleed

Devarsh N Shah*, Harshal Prakashbhai Chorya, Palak Patel

Takayasu Arteritis is a large and medium vessel vasculitis mainly affecting the aorta and its branches. The early stages of the disease pose a diagnostic challenge due to the absence of specific symptoms, but as the condition progresses, patients may present with more recognizable signs such as the absence of a pulse and a range of other cardiovascular and neurological manifestations, some of which can be fatal. One such manifestation, which this patient presented with, is Subarachnoid Haemorrhage (SAH). SAH typically occurs as a result of the rupture of aneurysmal dilatation of the cerebral arteries due to chronic inflammatory changes to the vessel wall. However, in some cases, it can also manifest spontaneously, as observed in this particular patient without any evidence of cerebral aneurysms. The underlying mechanism for this finding is poorly understood but can be attributed to the rupture of newly developed collateral blood vessels, which form as a compensatory response to chronic hypo perfusion caused by the abnormal narrowing of cranial arteries. The condition can be managed conservatively with corticosteroids, and worsening prevented with modern surgical interventions. In conclusion, it is important to reach the diagnosis of Takayasu Arteritis and initiate subsequent management at the earliest to prevent fatal outcomes. Also importantly, further research is required into understanding the pathophysiology behind the development of non-aneurysmal subarachnoid haemorrhage in Takayasu Arteritis which can aid in developing preventive and treatment options for the same