A Young Woman Presented with Recurrent Multifocal Ischemic Stroke and Systemic Autoimmune Disease: A Case Report
Keywords:
ischemic stroke, systemic autoimmune disease, CNS vasculitis, vessel wall imagingAbstract
We report a case of ischemic stroke coexisted with the systemic autoimmune disease in a 35-year-old woman presented with left hemiparesis and right hemiparesthesia for 2 months without headache or prior head injury. Next month later, she presented with hair loss, malar and skin rash in sun exposed area. The brain imaging study detected chronic infarction of left posterior inferior cerebellar artery (PICA) territory involving inferior aspect of left cerebellar hemisphere and left posterolateral aspect of medulla, and the vessel wall imaging demonstrated multifocal eccentric and concentric wall thickening and enhancement at left intradural vertebral artery and V3 of left extraspinal vertebral artery. The laboratory test was found that high level of antinuclear antibody (ANA). Systemic lupus erythematosus (SLE) with CNS vasculitis was diagnosed after clinical symptoms, laboratory results and vascular studies were excluded other differential diagnosis, such as reversible cerebral vasoconstriction syndrome (RCVS) and vertebral artery dissection (VAD).
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