Abstract
We describe two cases of non-aneurysmal subarachnoid hemorrhage (SAH) and multifocal stenosis of the intracranial arteries. The patients' histories together with magnetic resonance angiography, vessel wall imaging and transcranial Doppler (TCD) indicated that the SAH was due to vasculitis or reversible cerebral vasoconstriction syndrome (RCVS). Differential diagnosis of vasculitis and RCVS is important because the treatment strategies are different: immunosuppressants in vasculitis and calcium channel blockers in RCVS. Vessel wall magnetic resonance imaging and TCD can be helpful in differentiating them.
Keywords:
reversible cerebral vasoconstriction syndrome; subarachnoid hemorrhage; systemic lupus erythematosus.
© 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.
MeSH terms
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Adult
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Cerebral Angiography / methods
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Cerebral Arterial Diseases / diagnostic imaging
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Cerebral Arterial Diseases / drug therapy
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Cerebral Arterial Diseases / etiology*
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Cerebral Arterial Diseases / physiopathology
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Cerebral Arteries / diagnostic imaging
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Cerebral Arteries / drug effects
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Cerebral Arteries / physiopathology*
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Computed Tomography Angiography
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Diagnosis, Differential
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Female
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Humans
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Immunosuppressive Agents / therapeutic use
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Lupus Erythematosus, Systemic / complications*
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Lupus Erythematosus, Systemic / diagnosis
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Lupus Erythematosus, Systemic / drug therapy
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Magnetic Resonance Angiography
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Predictive Value of Tests
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Subarachnoid Hemorrhage / diagnostic imaging
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Subarachnoid Hemorrhage / drug therapy
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Subarachnoid Hemorrhage / etiology*
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Subarachnoid Hemorrhage / physiopathology
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Treatment Outcome
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Vasoconstriction* / drug effects
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Vasodilator Agents / therapeutic use
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Young Adult
Substances
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Immunosuppressive Agents
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Vasodilator Agents