Neurological Surgery No Shinkei Geka Volume 28, Issue 11 (November 2000)

A Case of Left Occipital Lobe Hemorrhage in a Patient with Progressive Systemic Sclerosis : Evaluation of Cerebral Angiography and Histology Hirotsugu YUKAWA 1 , Yoshitaka KUBO 1 , Yasunari OTAWARA 1 , Akira KUDO 1 , Nobuhiko TOMITSUKA 1 , Kenji YOSHIDA 1 , Akira OGAWA 1 , Ken KUROSE 2 , Michiyasu SUZUKI 3 , Saneyuki CHIBA 4 1Department of Neurosurgery, Iwate Medical University 2Department of Pathology, Iwate Medical University 3Department of Neurosurgery, Yamaguchi University 4Department of Internal Medicine, National Sanatorium Morioka Hospital Keyword: intracerebral hemorrhage , progressive systemic sclerosis , cerebral angiography , vasculitis , histology pp.1003-1007
Published Date 2000/11/10
  • Abstract
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Involvement of the central nervous system is uncommon in progressive systemic sclerosis, with only 2 reported cases associated with intracerebral hemorrhage detected by neuroimaging.

A 55-year-old woman with a 10-year history of scleroderma presented with left occipital lobe hemor-rhage manifesting as headache and vomiting. She had no signs of hypertension, diabetes mellitus and hyperlipidemia. CT and MRI, on admission, showed left occipital lobe hemorrhage with ventricular rupture and acute left subdural hematoma. Serial cerebral angiography was performed on day 0, day 7 and day 14, and found no evidence of aneurysm, arteriovenous multiformation or tumor stain in the left occipital lobe. However, the bilateral anterior cerebral arteries showed increasing segmental narrrowing suggestive of vasculitis. Histological examination of a section from the brain cortex adjacent to the hemorrhage revealed no evidence of vasculitis, fibrinoid degeneration or amyloid deposition. Focal vasculitis may have occured secondary to the homorrhagic lesion.

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Neurological Surgery 脳神経外科
28巻11号 (2000年11月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院