Strokes in Systemic Lupus Erythematosus —Case Report—

Abstract

A patient with systemic lupus erythematosus (SLE) suffered, in rapid sequence, subarachnoid hemorrhage, intracerebral hemorrhage, and cerebral infarction. Small, irregular-shaped aneurysms were present on the left anterior temporal and anterior choroidal arteries. During angiography, extravasation from the second portion of the left middle cerebral artery was recognized, and a subsequent CT scan showed a massive, hyperdense lesion in the temporal lobe. A fusiform aneurysm in the posterior communicating artery was examined histologically and proved to be affected by vasculitis. The patient died of occlusion of the right internal carotid artery. We present the clinical and pathological aspects of aneurysms in SLE patients and discuss their pathogenesis and clinical management. © 1987, The Japan Neurosurgical Society. All rights reserved.