title: Histopathological analysis of cerebral hemorrhage in systemic lupus erythematosus complicated with antiphospholipid syndrome.
abstract: A 53-year-old woman was admitted due to akinetic mutism and fever. On admission, brain computed tomography (CT) scan revealed a large hemorrhagic lesion in the left anterior lobe that required surgical operation for total removal. Her neuropsychiatric manifestation was not attenuated after the operation, and was gradually ameliorated by high doses of corticosteroid thereafter, suggesting a diagnosis of lupus psychosis. Histopathological examination revealed a necrotizing vasculature, sometimes with a disrupted lamina elastica interna, completely filled with thrombi and infiltrated with inflammatory cells and their debris. It is therefore suggested that the large frontal lobe hematoma in our patient was induced by thrombosis and arteritis in the subarachnoid space.
authors.affiliation: Department of Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Kanagawa, 252-0392, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Arinuma
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Kikuchi
authors.forename: Kaori
authors.initials: K
authors.lastname: Aramaki
authors.forename: Masahisa
authors.initials: M
authors.lastname: Kyogoku
authors.forename: Shunsei
authors.initials: S
authors.lastname: Hirohata
mesh_terms: D016736:Antiphospholipid Syndrome / Q000150:complications*; D001706:Biopsy; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D020767:Intracranial Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D020945:Lupus Vasculitis, Central Nervous System / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D014057:Tomography, X-Ray Computed