Numerous Fusiform and Saccular Cerebral Aneurysms in Central Nervous System Lupus Presenting with Ischemic Stroke

Shahram Majidi; Christopher R Leon Guerrero; Shreya Gandhy; Kathleen M Burger; Dimitri Sigounas

doi:10.1016/j.jstrokecerebrovasdis.2017.03.040

Numerous Fusiform and Saccular Cerebral Aneurysms in Central Nervous System Lupus Presenting with Ischemic Stroke

J Stroke Cerebrovasc Dis. 2017 Jul;26(7):e126-e128. doi: 10.1016/j.jstrokecerebrovasdis.2017.03.040. Epub 2017 May 4.

Authors

Shahram Majidi¹, Christopher R Leon Guerrero², Shreya Gandhy², Kathleen M Burger², Dimitri Sigounas³

Affiliations

¹ Department of Neurology, George Washington University, Washington, DC. Electronic address: [email protected].
² Department of Neurology, George Washington University, Washington, DC.
³ Department of Neurosurgery, George Washington University, Washington, DC.

PMID: 28479183
DOI: 10.1016/j.jstrokecerebrovasdis.2017.03.040

Abstract

Central nervous system (CNS) involvement occurs in up to 50% of patients with systemic lupus erythematosus (SLE). Cerebral aneurysm formation is a rare complication of CNS lupus. The majority of these patients present with subarachnoid hemorrhage. We report a patient with an active SLE flare who presented with a recurrent ischemic stroke and was found to have numerous unruptured fusiform and saccular aneurysms in multiple vascular territories. He was treated with high-dose steroid and rituximab along with aspirin and blood pressure control for stroke prevention.

Keywords: CNS lupus; Cerebral aneurysm; ischemic stroke; systemic lupus erythematosus.

Publication types

Case Reports

MeSH terms

Adult
Antihypertensive Agents / therapeutic use
Aspirin / therapeutic use
Brain Ischemia / diagnostic imaging
Brain Ischemia / etiology*
Brain Ischemia / prevention & control
Cerebral Angiography
Diffusion Magnetic Resonance Imaging
Humans
Immunosuppressive Agents / therapeutic use
Intracranial Aneurysm / diagnostic imaging
Intracranial Aneurysm / drug therapy
Intracranial Aneurysm / etiology*
Lupus Vasculitis, Central Nervous System / complications*
Lupus Vasculitis, Central Nervous System / diagnostic imaging
Lupus Vasculitis, Central Nervous System / drug therapy
Male
Platelet Aggregation Inhibitors / therapeutic use
Recurrence
Rituximab / therapeutic use
Steroids / therapeutic use
Stroke / diagnostic imaging
Stroke / etiology*
Stroke / prevention & control
Treatment Outcome

Substances

Antihypertensive Agents
Immunosuppressive Agents
Platelet Aggregation Inhibitors
Steroids
Rituximab
Aspirin