1987 Volume 9 Issue 1 Pages 43-47
A case of ruptured cerebral aneurysm in a patient with systemic lupus erythematosus (SLE) was reported.
A 47-year-old woman complained of a severe headache, vomiting and consciousness disturbance on November 4th, 1983 and was admitted to the internal medicine ward, at Yamaguchi University Hospital.
A CT scan performed on the first day on admission showed a subarachnoid hemorrhage, so she was immediatly transferred to our clinic. She had a past history of subarachnoid hemorrhage 7 years previously, and a cerebral angiogram performed at that time showed a tiny aneurysm at the distal anterior cerebral artery.
She was medically treated at that time because she was known to have had SLE for the previous 5 years.
On admission, she was in a drowsy state and appeared cushingoid and in moderate discomfort from headache with stiff neck but showed no paresis and sensory distrubance on limbs.
A four-vessel angiogram performed via the femoral route showed a saccular aneurysm at the junction of the pericallosal artery and the callosomarginal artery which had increased in size to about 4 mm in diameter.
The patient's consciousness level markedly improved after intravenously administered glycerol, so she was operated on November 10th, 1983. The operative course was uneventful and a postoperative angiogram showed complete obliteration of the aneurysm.
This is the first report in which a radical operation on confirmed cerebral aneurysm in SLE was performed. The pathogenesis of cerebral aneurysm in a SLE is discussed.
