An evolving case of headaches and strokes

The median age of onset is approximately 50 years and men are affected twice as often as women. 4 - 6 The commonest presenting symptom is headache-usually slowly progressive-and encephalopathy, with symptoms and signs of vasculitis outside the CNS extremely rare. [...]it was important to exclude all secondary causes of vasculopathy. Unfortunately, on the evening of surgery he became mildly dysarthric and developed right upper motor neuron facial weakness and right-sided hemiparesis (Medical Research Council grade 4/5).