Intractable Progressive Cerebral Infarction with Multiple Atypical Aneurysms in Systemic Lupus Erythematosus

Abstract

Systemic lupus erythematosus (SLE) is a rare etiology of stroke in young patients. The relative risk for ischemic and hemorrhagic stroke in SLE is two- and three-folds higher, respectively, than those in the general population.1,2 The neuropathologic findings of neuropsychiatric SLE (NPSLE) show the highest incidence of non-vasculitic vasculopathy of small arterioles and capillaries; however, cerebral vasculitis involving small vessels, including arteries and veins, is relatively low with an incidence of 7–13%.3,4 The SLE-associated vasculitis induces cerebrovascular events, including rare forms of intracranial aneurysms and subarachnoid hemorrhage.5 Herein, we report a case of intractable, progressive cerebral infarction in an SLE patient presenting evidence of vasculitis involving cerebral arteries with multiple cerebral aneurysms and suspicious vasculitis involving cerebral veins.