Systemic sclerosis, transient neurological symptoms, and macrovascular disease.

disorder of unknown etiology, characterized by sclerotic skin and /or multisystem internal organ involvement. Severe secondary Raynaud’s phenomenon due to vasospasm and intimal proliferation in small vessels frequently leads to digital ulceration and ischemia. Internal organ manifestations variably involve the gastrointestinal, renal, cardiac, and pulmonary systems. Neurological symptoms are uncommon but include myopathy, cranial neuropathies, peripheral neuropathy and, rarely, myelopathy1,2. Cerebrovascular symptoms are particularly rare and usually attributed to complications of renal or cardiopulmonary disease2. We describe a patient with systemic sclerosis who presented with cerebral and ocular ischemic symptoms and occlusive disease involving multiple large vessels at the base of the neck.