We report of a case of systemic lupus erythematosus (SLE) complicated by multiple ruptured cerebral aneurysms. The patient was a 33-year-old female with a 5-year history of SLE. The onset of the complication was marked by a headache, and subsequent cerebral angiography revealed multiple aneurysms in the vertebro-basilar system.
A clipping of aneurysms was performed on the day of hospitalization, but the patient died on the 31st day due to renal insufficiency. Although SLE complicated by cerebrovascular disease is not rare, SLE associated with ruptured cerebral aneurysm is encountered less often than expected.
As for the prognosis, 15 of 23 reported cases, including the present one, were fatal. In addition, 6 of 8 patients suffering from multiple aneurysms died, indicating an extremely poor prognosis for this type of disease. Further deterioration of the prognosis may be explained by the difficulty in identifying a ruptured aneurysm as well as the extended vasculitis and fragility of such a lesion.
