A rare case presentation of Takayasu arteritis affecting the bilateral common carotid arteries: a case report.

Introduction and importance: Takayasu arteritis (TAK) is a rare chronic vasculitis that predominantly affects the aorta and its primary branches, with a strong predilection for young women. Its atypical presentation, particularly involving the common carotid arteries, poses significant diagnostic challenges. This case report highlights the clinical and diagnostic complexity of TAK, underscoring the need for timely intervention to prevent severe complications. Case presentation: A 27-year-old woman presented with an 8-month history of dizziness, light-headedness, and positional vision changes, accompanied by severe back pain for three months and a 2-week history of throat burning. MR angiography and carotid Doppler confirmed circumferential arterial wall thickening and high-grade bilateral stenosis of the common carotid arteries, leading to the diagnosis of TAK. The patient was managed conservatively with methylprednisolone, achieving disease control and symptom improvement. Clinical discussion: This case emphasizes the varied clinical spectrum of TAK, from systemic symptoms to critical vascular involvement. It illustrates the importance of advanced imaging modalities, such as MR angiography, in diagnosing TAK, particularly in its atypical presentations. The management underscores the role of corticosteroids and immunosuppressive therapy in controlling inflammation and preventing disease progression. A multidisciplinary approach proved essential in achieving clinical stability. Conclusion: This report highlights the clinical complexity and diagnostic challenges of TAK, emphasizing the importance of early recognition and a tailored therapeutic approach. Sharing such cases enriches understanding and promotes prompt, effective management of rare vasculitic conditions.