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巨细胞动脉炎(GCA)很少致命,尸检材料很少。临床症状包括头痛、口歪、发热、厌食和视力丧失,并伴有不典型脑缺血症状。易误诊为动脉硬化引起的缺血性中风。血沉增快及颞动脉活检阳性改变,有助于证实或否定诊断。GCA是可以治疗的,可使症状改善。作者报道的3例巨细胞动脉炎为1男2女,年龄分别为80、86和65岁。主要症状为头痛、厌食、口歪、发热和视力丧失。血沉分别为90、110和83mm/h。早期,视力正常,无眼部症状。中、晚期,视力急剧下降,光反射迟缓或消失,视盘水肿。颞动脉活检呈GCA的典型改变。初诊时易误诊为缺血性视神经病变。用皮质类固醇治疗,早期可使症状缓解。尸检查颅内无GCA的改变。作者报道的3例GCA典型改变见于颞动脉。两例与GCA有关的脑血管病人,尸检查不出颅内GCA。其脑梗塞是由于颅外血管的栓塞,颅外血管的损害是动脉炎、动脉粥样化和血栓形成,而不是由于脑内动脉本身的损害。一些报道提出颅内血管也受侵犯(虽不多见)。尸检的结果最可靠,证明侵犯颈内动脉、椎动脉和基底动脉的颅内段和大脑基底动脉,
Giant cell arteritis (GCA) rarely fatal, autopsy material rarely. Clinical symptoms include headache, crooked mouth, fever, anorexia and vision loss, accompanied by atypical ischemic symptoms. Easily misdiagnosed as atherosclerosis caused by ischemic stroke. Erythrocyte sedimentation rate and temporal artery biopsy positive change, help confirm or deny the diagnosis. GCA is treatable and can improve symptoms. The authors reported 3 cases of giant cell arteritis 1 male and 2 female, aged 80, 86 and 65 years old. The main symptoms are headache, anorexia, crooked mouth, fever and loss of vision. ESR were 90,110 and 83mm / h respectively. Early, normal vision, no eye symptoms. Medium and late, sharp decline in visual acuity, light reflex or disappear, optic disc edema. Temporal artery biopsy showed a typical change of GCA. Misdiagnosed as initial ischemic optic neuropathy. Corticosteroid treatment, early symptoms can be alleviated. Postmortem examination of intracranial GCA-free changes. The authors report 3 cases of typical changes in GCA found in the temporal artery. Two cases of GCA-related cerebrovascular disease, autopsy can not find intracranial GCA. Cerebral infarction is due to embolization of the extracranial vessels, which are arteritis, atherosclerosis, and thrombosis, not due to damage to the arteries inside the brain. Some reports suggest that intracranial blood vessels are also infringed (although rare). The autopsy results are the most reliable, proving violations of the intracranial segments of the internal carotid, vertebral and basilar arteries and the basilar artery of the brain,