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KMID : 1034720210130020071
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Journal of Neurosonology and Neuroimaging
2021 Volume.13 No. 2 p.71 ~ p.75
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Intractable Progressive Cerebral Infarction with Multiple Atypical Aneurysms in Systemic Lupus Erythematosus
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Lee Jong-Min
Kim Hyun-Young
Kim Young-Seo
Bae Sang-Cheol
Lee Ji-Young
Lee Young-Jun
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Abstract
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We report a case of intractable progressive cerebral infarction with multiple fusiform aneurysms in a 34-year-old female patient with systemic lupus erythematosus (SLE), non-responsive to massive immunotherapy. The patient visited the emergency department with dysarthria and left-sided hemiparesis that occurred 2 days before. She was diagnosed with SLE involving the brain and received 12 cycles of cyclophosphamide 12 years prior. Brain diffusion-weighted imaging showed acute infarctions involving the pons and medulla. Additionally, multifocal microbleeding-like signals in various cisternal spaces were detected using susceptibility-weighted imaging. Digital subtraction angiography revealed multiple fusiform aneurysms. Despite antithrombotic treatment with trif lusal and immunotherapies, including corticosteroids, mycophenolate mofetil, and immunoglobulins, for cerebral vasculitis associated infarction, her neurologic deficits worsened with recurrent cerebral infarction. Further investigation for accurate diagnosis and treatment is required.
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KEYWORD
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Cerebral infarction, Intracranial aneurysm, Lupus erythematosus, systemic
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