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

Journal: International journal of rheumatic diseases 2018;21(3):761-766

PMID: 27453474

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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.

Address: Department of Radiology, Hanyang University College of Medicine, Hanyang University Hospital, Seoul, South Korea.; Department Neurology, Hanyang University College of Medicine, Hanyang University Hospital, Seoul, South Korea.; Department of Radiology, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, South Korea.; Department of Rheumatology, Hanyang University College of Medicine, Hanyang University Hospital, Seoul, South Korea.

DOI: 10.1111/1756-185X.12867

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MeSH Terms: Adult, Cerebral Angiography, Cerebral Arterial Diseases, Cerebral Arteries, Computed Tomography Angiography, Diagnosis, Differential, Female, Humans, Immunosuppressive Agents, Lupus Erythematosus, Systemic, Magnetic Resonance Angiography, Predictive Value of Tests, Subarachnoid Hemorrhage, Treatment Outcome, Vasoconstriction, Vasodilator Agents, Young Adult