Non-aneurysmal subarachnoid hemorrhage in two patients with systemic lupus erythematosus: Case reports and literature review

Ji Young Lee; Young Seo Kim; Hyun Young Kim; Dong Woo Park; Sang-Cheol Bae; Young-Jun Lee

doi:10.1111/1756-185X.12867

Non-aneurysmal subarachnoid hemorrhage in two patients with systemic lupus erythematosus: Case reports and literature review

Int J Rheum Dis. 2018 Mar;21(3):761-766. doi: 10.1111/1756-185X.12867. Epub 2016 Jul 25.

Authors

Ji Young Lee¹, Young Seo Kim², Hyun Young Kim², Dong Woo Park³, Sang-Cheol Bae⁴, Young-Jun Lee¹

Affiliations

¹ Department of Radiology, Hanyang University College of Medicine, Hanyang University Hospital, Seoul, South Korea.
² Department Neurology, Hanyang University College of Medicine, Hanyang University Hospital, Seoul, South Korea.
³ Department of Radiology, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, South Korea.
⁴ Department of Rheumatology, Hanyang University College of Medicine, Hanyang University Hospital, Seoul, South Korea.

PMID: 27453474
DOI: 10.1111/1756-185X.12867

Abstract

We describe two cases of non-aneurysmal subarachnoid hemorrhage (SAH) and multifocal stenosis of the intracranial arteries. The patients' histories together with magnetic resonance angiography, vessel wall imaging and transcranial Doppler (TCD) indicated that the SAH was due to vasculitis or reversible cerebral vasoconstriction syndrome (RCVS). Differential diagnosis of vasculitis and RCVS is important because the treatment strategies are different: immunosuppressants in vasculitis and calcium channel blockers in RCVS. Vessel wall magnetic resonance imaging and TCD can be helpful in differentiating them.

Keywords: reversible cerebral vasoconstriction syndrome; subarachnoid hemorrhage; systemic lupus erythematosus.

Publication types

Case Reports
Review

MeSH terms

Adult
Cerebral Angiography / methods
Cerebral Arterial Diseases / diagnostic imaging
Cerebral Arterial Diseases / drug therapy
Cerebral Arterial Diseases / etiology*
Cerebral Arterial Diseases / physiopathology
Cerebral Arteries / diagnostic imaging
Cerebral Arteries / drug effects
Cerebral Arteries / physiopathology*
Computed Tomography Angiography
Diagnosis, Differential
Female
Humans
Immunosuppressive Agents / therapeutic use
Lupus Erythematosus, Systemic / complications*
Lupus Erythematosus, Systemic / diagnosis
Lupus Erythematosus, Systemic / drug therapy
Magnetic Resonance Angiography
Predictive Value of Tests
Subarachnoid Hemorrhage / diagnostic imaging
Subarachnoid Hemorrhage / drug therapy
Subarachnoid Hemorrhage / etiology*
Subarachnoid Hemorrhage / physiopathology
Treatment Outcome
Vasoconstriction* / drug effects
Vasodilator Agents / therapeutic use
Young Adult

Substances

Immunosuppressive Agents
Vasodilator Agents