Work

Intracranial Giant Cell Arteritis Progressing despite Treatment with High Doses of Corticosteroids: Case Report

Year: 2026

Type: article

Abstract: Introduction: We describe a man with severe unilateral visual loss from giant cell arteritis who had normal inflammatory markers and exhibited progression of intracranial vasculitis while on high doses of corticosteroids. Case: A 64-year-old man presented with unilateral visual loss. He had systemic symptoms of giant cell arteritis (GCA); however, both inflammatory markers were normal. He was diagnosed with arteritic anterior ischemic optic neuropathy after temporal artery biopsy revealed classic findings of GCA and treated with high-dose corticosteroids. Despite appropriate treatment, serial imaging revealed progressive narrowing of intracranial arteries, predominantly involving anterior circulation of the brain. Conclusion: This case highlights that GCA can rarely present with normal inflammatory markers, involve intracranial vasculature, and progress despite treatment with high doses of corticosteroids emphasizing the importance of advanced imaging and potential need for adjunctive immunosuppressive therapy in patients with refractory disease.

Source: Case Reports in Ophthalmology

DOI: 10.1159/000550515

Authors: Niv Levi, Alexandre Boutet, Edward Margolin

Institution: University of Toronto

Language: English

Topic: Vasculitis and related conditions

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,030