Cerebral Vertebral Artery Vasculitis Presenting as Neck Pain and Fever

The patient, a 64-year-old man, was admitted to our hospital with a 6-week history of intermittent neck pain, posterior headaches, fever (39°C), and inflammatory syndrome (persistently elevated C-reactive protein level [~200 mg/liter]). Because of a dry cough, bronchopneumonia was initially suspected; however, antibiotics were not effective. He had not experienced vision loss or jaw or limb claudication and was not experiencing any headache at the time of admission. He had been diagnosed as having polymyalgia rheumatica (PMR) 3 years prior, which was still being treated with methotrexate.