Yoshimoto T, Ueno K, Ihara T, Katou I, Hashizume K, Minoshima S
Department of Neurological Surgery, Hokkaidou-daiichi Hospital, Japan.
No Shinkei Geka. 1989 May;17(5):489-93.
According to the past reports, neuropsychiatric manifestations have been seen in 10-75% of patients with systemic lupus erythematosus and are second only to renal involvement as a cause of death. The clinical feature is multiple. And cerebrovascular diseases due to systemic lupus erythematosus are detected in 3-16% of the neuropsychiatric manifestations. Occlusion of the intracranial major arteries is less frequently found in other cerebrovascular diseases. And central nervous system involvement usually occurs at some intermediate or terminal stage of systemic lupus erythematosus, so is rarely regarded as one of the initial symptoms. We studied the case of a patient with systemic lupus erythematosus with occlusion of the right middle cerebral artery indicated by angitis and 'string of beads' appearance of the right internal carotid artery indicated by fibromuscular dysplasia. The patient was a 38 year old female and began to feel weakness in the left hand and developed mild-left hemiparesis due to infarction of right temporo-parieto-occipital lesion which was revealed by CT scan. Carotid angiograph showed irregularity at the right middle cerebral artery and 'string of beads' appearance of the right internal carotid artery. Gradually neurological manifestations improved, but a facial 'butterfly' rash, palmar erythema and polyarthritis were detected.(ABSTRACT TRUNCATED AT 250 WORDS)
根据以往报告，10%至75%的系统性红斑狼疮患者会出现神经精神症状，其作为死因仅次于肾脏受累。临床特征多样。在神经精神症状中，3%至16%的患者存在因系统性红斑狼疮导致的脑血管疾病。颅内主要动脉闭塞在其他脑血管疾病中较少见。而且中枢神经系统受累通常发生在系统性红斑狼疮的某个中期或晚期阶段，因此很少被视为初始症状之一。我们研究了一例系统性红斑狼疮患者，其右大脑中动脉闭塞由血管炎提示，右颈内动脉“串珠样”表现由纤维肌发育不良提示。该患者为38岁女性，因右颞顶枕叶梗死出现左手无力并发展为轻度左侧偏瘫，CT扫描显示了这一病变。颈动脉血管造影显示右大脑中动脉不规则以及右颈内动脉“串珠样”表现。神经症状逐渐改善，但发现有面部“蝶形”皮疹、手掌红斑和多关节炎。（摘要截选至250字）
