Intravenous Methylprednisolone for Acute Right Middle Cerebral Artery Occlusion in Granulomatosis Polyangiitis
A 17-year-old Japanese woman diagnosed with granulomatosis with polyangiitis (GPA) and was treated with immunotherapy suddenly developed an impaired consciousness, left hemiplegia, and conjugate eye deviation to the right. Magnetic resonance imaging showed an acute cerebral infarction in the right striatum and right middle cerebral artery (MCA) occlusion. As her GPA had worsened recently, intravenous methylprednisolone (IVMP) was started. Immediately after IVMP was started, recanalization of the MCA was detected on repeat cerebral angiography. Aspirin and argatroban dissolved the residual thrombi. A combination of IVMP and antithrombotic therapy may be effective for large-vessel occlusions associated with GPA.
Authors
- Hideyuki Yoshioka (ORCID: https://orcid.org/0000-0002-6469-7156)
- Sho Nakajima (ORCID: https://orcid.org/0000-0001-8022-6226)
- Tsubasa Watanabe (ORCID: https://orcid.org/0000-0002-2058-335X)
- Ryosuke Ito (ORCID: https://orcid.org/0000-0001-6546-3696)
- Yuji Ueno (ORCID: https://orcid.org/0000-0002-8617-3695)
- Koji Hashimoto (ORCID: https://orcid.org/0000-0002-2327-6777)
- Hiroyuki Kinouchi (ORCID: https://orcid.org/0000-0003-0841-5502)
- Daiki Nakagomi (ORCID: https://orcid.org/0000-0003-1682-9799)
- Yuto Morishima
- Kazumasa Shindo (ORCID: https://orcid.org/0000-0001-8237-3916)
- Atsuhiko Shindo (ORCID: https://orcid.org/0000-0002-6936-2478)
- Yuki Nakamura (ORCID: https://orcid.org/0000-0003-4931-2489)
- Nakako Tanaka‐Mabuchi (ORCID: https://orcid.org/0009-0005-3929-4215)
- Takanori Hata
Institutions
- University of Yamanashi (JP)
Publication Details
- Journal
- Internal Medicine
- Published
- 2025-04-11
- DOI
- https://doi.org/10.2169/internalmedicine.4873-24
- Primary Topic
- Vasculitis and related conditions
- Type
- article
- Field-Weighted Citation Impact
- 0.00