takayasu 's arteritis is a chronic inflammatory disease that afflicts the aorta and its principal branches as well as the pulmonary artery , resulting in the formation of aneurisms and arterial stenosis . in general pre - pulseless phase , characterized by constitutional symptoms such as fever , weight loss , arthralgia , myalgia , lethargy and mild anemia , and a later or neurological symptoms occur in 50% of cases and most commonly include headache , dizziness , visual disturbances , convulsive crisis , transient ischemic attack , stroke and posterior reversible encephalopathy syndrome . a 19-year - old caucasian female from brazil was admitted with focal neurological deficit 3 days after symptom onset . she presented asymmetry of brachial and radial pulses , aphasia , dysarthria and right hemiplegia . 1 ) . cerebral angiography displayed occlusion of the right subclavian and left common carotid arteries , stenosis of the brachiocephalic trunk and flow inversion of the right vertebral artery and left posterior communicating artery , irrigating the territory of the left common carotid artery ( fig . only nonspecific inflammatory markers such as velocity of hemosedimentation and c - reactive protein were elevated . during hospitalization , clinical treatment was performed using pulse therapy with methylprednisolone 1 g / day for 3 days as well as methotrexate 15 mg / day , acetylsalicylic acid 200 mg / day and simvastatin 20 mg / day . after pulse therapy , prednisone 60 mg / day was initiated , showing progressive neurological recuperation on the subsequent days . after 4 months , the patient was submitted to medicated angioplasty of the brachiocephalic trunk with paclitaxel , with significant improvement of the stenosis . at the 6-month follow - up , the neurological exam presented mild dysarthria , faciobrachial predominant disproportionate hemiparesis , an nihss score of 4 and a modified rankin scale score of 3 ( moderate incapacity ) . stroke incidence in this disease is 1020% , but stroke as a first manifestation of takayasu 's arteritis in young patients is rarely found in the literature . the patient in this study did not show any systemic manifestations at any moment during the clinical follow - up , which also leads to an uncommon form of presentation of the disease . the stroke mechanisms in takayasu 's arteritis are described as embolism of stenotic or occlusive lesions of the aortic arch and its branches , hypertension , cardioembolism and cerebral hypoflow . the principal objective of the clinical treatment of takayasu 's arteritis is to control the activity of the disease , thus achieving radiological and clinical improvement . invasive treatments including angioplasty and vascular surgery ( bypass ) must be considered only for stenoses or occlusions of critical arteries such as renal arteries , common carotid and internal carotid arteries . in our case , there was a delay in the diagnosis because the symptoms were associated with a psychiatric condition . in conclusion , takayasu 's arteritis must be recognized as a potential cause of ischemic stroke in young females .
takayasu 's arteritis is a chronic inflammatory disease , and neurological symptoms occur in 50% of cases , most commonly including headache , dizziness , visual disturbances , convulsive crisis , transient ischemic attack , stroke and posterior reversible encephalopathy syndrome . 
 the aim of this study was to report the case of a young brazilian female with a focal neurological deficit . 
 she presented with asymmetry of brachial and radial pulses , aphasia , dysarthria and right hemiplegia . 
 stroke was investigated extensively in this young patient . 
 only nonspecific inflammatory markers such as velocity of hemosedimentation and c - reactive protein were elevated . during hospitalization , clinical treatment 
 was performed with pulse therapy showing improvement in neurological recuperation on subsequent days . in the chronic phase , 
 the patient was submitted to medicated angioplasty of the brachiocephalic trunk with paclitaxel , with significant improvement of the stenosis . at the 6-month follow - up , 
 the neurological exam presented mild dysarthria , faciobrachial predominant disproportionate hemiparesis , an nihss score of 4 and a modified rankin scale score of 3 ( moderate incapacity ) . in conclusion 
 , takayasu 's arteritis must be recognized as a potential cause of ischemic stroke in young females .