Which large vessel vasculitis will have neurological deficits?

• A. Giant cell arteritis
• B. Takayasu arteritis
• C. Polyarteritis nodosa
• D. Churg-Strauss

Answer: (B)

In large-vessel vasculitis, inflammation of the aorta and its major branches can narrow the vessels that supply the brain, leading to neurological symptoms. Takayasu arteritis specifically targets the aorta and great branches, including the carotid and vertebral arteries, which can cause cerebral hypoperfusion and result in dizziness, transient ischemic attacks, or strokes. It often presents in younger women and can also cause upper-extremity claudication and diminished pulses. Compared with other options, giant cell arteritis mainly involves branches of the external carotid and presents with headaches and visual symptoms; polyarteritis nodosa is a medium-vessel vasculitis and neuropathies are a feature but not due to brain-supplying large arteries; Churg-Strauss affects small to medium vessels with asthma and eosinophilia and neuropathy, not classic large-vessel brain ischemia.