Authors describe the case of a 16-year-old girl who presented with fever, 
tonic-clonic seizures, unequal arm blood pressures and pulselessness in the left 
upper limb. On examination, there was a systolic bruit over umbilical region, a 
pansystolic murmur of mitral regurgitation was found. Neurological examination 
was normal except for an asymmetry in brain hemicircumference one side compared 
with the other. She has borderline intelligence (IQ 70) according to Wechsler 
Adult Performance Intelligence Scale. Magnetic resonance imaging (MRI) of brain 
revealed atrophic of left cerebral hemisphere with mildly ventricular 
dilatation, prominent paranasal and mastoid air cells, suggestive of 
Dyke-Davidoff-Masson syndrome (DDMS). Conventional angiography showed narrowed 
left internal carotid artery. There was also stenosed brachial artery, absent 
left renal artery with narrowed infrarenal abdominal aorta. The patient was put 
on antihypertensive drugs. We hypothesise that Takayasu arteritis and related 
vascular occlusion is the cause of her acquired cerebral changes.