title: Stroke and mixed connective tissue disease.
abstract: We describe the clinical presentation and course of two girls with cerebrovascular disease and mixed connective tissue disease. One developed rapid onset hemiparesis and aphasia secondary to left internal carotid artery occlusion. She experienced a complete recovery after treatment with prednisone and cyclophosphamide. The other patient was diagnosed as having mixed connective tissue disease but had acute neurologic deterioration. She died due to an intracerebral hemorrhage. Autopsy demonstrated small-vessel fibrinoid necrosis. Although cerebrovascular disease secondary to central nervous system vasculitis is a manifestation of systemic lupus erythematosus, this is the first description of cerebrovascular disease as a primary sign in mixed connective tissue disease. These cases demonstrate the range of cerebrovascular disease observed in children with mixed connective tissue disease.
authors.affiliation: Department of Pediatrics, Children's Hospital and Medical Center, University of Washington, Seattle 98105.
authors.forename: W D
authors.initials: WD
authors.lastname: Graf
authors.forename: J M
authors.initials: JM
authors.lastname: Milstein
authors.forename: D D
authors.initials: DD
authors.lastname: Sherry
mesh_terms: D000293:Adolescent; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000209:etiology*; D002543:Cerebral Hemorrhage / Q000209:etiology*; D002648:Child; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008947:Mixed Connective Tissue Disease / Q000150:complications* / Q000175:diagnosis