Abstract
A rare case with systemic lupus erythematosus (SLE) accompanied by normal pressure hydrocephalus (NPH) and an unruptured aneurysm was reported. The relationship between clinical features and complications were discussed.
A 43-year-old female with a 11-year history of SLE was admitted to our hospital for evaluation of transient ischemic attack in December 1982. When she was admitted, she had butterfly rash, oral ulcer, nephritis, leukocytopenia and hypocomplementemia. The titers of antinuclear antibodies and anti-DNA antibodies elevated. There were no neurological abnormalities. The lumber puncture yielded clear, colorless cerebrospinal fluid under an opening pressure 130mmH2O; the fluid contained normal protein, glucose and cell values; antinuclear antibodies and anti-DNA antibodies were not detected. The electroencephalogram findings showed a mixture of slow waves. The computed tomography revealed marked ventricular enlargement. RI cisternography showed abnormal reflux to the ventricle and a greatly prolonged clearance time. Cerebral angiography demonstrated a saccular aneurysm at the junction of the right median and the striate arteries. A neck clipping operation was performed in February 1983. There was no evidence of thickned leptomeninges or fibrosis of the arachnoid villi. The biopsy tissue demonstrated the degeneration of nerve cells and proliferation of oligodendrocytes, which may be due to ischemia. There was no evidence of angitis with deposition of immune complexes. The operative therapy for the hydrocephalus was not performed and the patient is under careful observation.
