KADRİYE AĞAN YILDIRIM, Nazire AFŞAR, Ayca SUN, Sevinç AKTAN

Bilateral vertebral arter diseksiyonu ile ortaya çıkan sistemik lupus eritematozus: Olgu sunumu

Servikokranial arter diseksiyonu iskemik inmeler arasında özellikle genç yaşta oldukça sık rastlanan bir durumdur. Nadiren iskeminin dışında hemoraji ile de prezente olabilir. Sistemik lupus eritematozus genellikle serebral büyük damarlarda inflamatuar vaskülopati ile oklüzyona neden olmakla birlikte nadir arter diseksiyon nedenleri arasında yer almaktadır. Bu yazıda bilateral vertebral arter diseksiyonu sonucu iskemi ve subaraknoid kanamanın beraber izlendiği bir olgu sunulmaktadır.

Anahtar Kelimeler:

Erişkin, Diseksiyon, Kadın, Lupus eritematozus, sistemik, Tomografi, x-ışınlı bilgisayarlı, İnme, Subaraknoid kanama, Vertebral arter

Systemic lupus erythematosus presenting with bilateral vertebral artery dissection: Case report

Ischemic stroke due to cervicocranial artery dissections is a relatively common situation especially in the young population. Rarely it may present with intracranial hemorrhage rather than ischemia. Systemic lupus erythematosus usually cause occlusive disease of large cerebral vessels by means of inflammatory vasculopathy and sometimes arterial dissection. A case presenting with both ischemia and subarachnoid hemorrhage due to bilateral vertebral artery dissection will be discussed in the present study.

Keywords:

Adult, Dissection, Female, Lupus Erythematosus, Systemic, Tomography, X-Ray Computed, Stroke, Subarachnoid Hemorrhage, Vertebral Artery,

PDF

___

1) Leys D, Lucas C, Gobert M, Deklunder G, Pruvo JP. Cervical artery dissections. Eur Neurol 1997;37:3-12.
2) Stahmer SA, Raps EC, Mines DI. Carotid and vertebral artery dissections. Emerg Med Clin North Am 1997;15:677-98.
3) Schievink WI. Spontaneous dissection of the carotid and vertebral arteries. N Engl J Med 2001;344:898-906.
4) Mokri B, Houser OW, Sandok BA, Piepgras DG. Spontaneous dissections of the vertebral arteries. Neurology 1988;38:880-5.
5) Schievink WI, Mokri B, O'Fallon WM. Recurrent spontaneous cervical-artery dissection. N Engl J Med 1994;330:393-7.
6) Leys D, Moulin T, Stojkovic T, Begey S, Chavot D, DONALD Investigators. Follow-up of patients with history of cervical artery dissection. Cerebrovasc Dis 1995;5:43-9.
7) Bassetti C, Carruzzo A, Sturzenegger M, Tuncdogan E. Recurrence of cervical artery dissection. A prospective study of 81 patients. Stroke 1996;27:1804-7.
8) García-Moncó JC, Fernández Cantón G, Gómez Beldarrain M. Bilateral vertebral artery dissection in a patient with afibrinogenemia. Stroke 1996;27:2325-7.
9) de Bray JM, Penisson-Besnier I, Dubas F, Emile J. Extracranial and intracranial vertebrobasilar dissections: diagnosis and prognosis. J Neurol Neurosurg Psychiatry 1997;63:46-51.
10) Chang AJ, Mylonakis E, Karanasias P, De Orchis DF, Gold R. Spontaneous bilateral vertebral artery dissections: case report and literature review. Mayo Clin Proc 1999;74:893-6.
11) Silbert PL, Mokri B, Schievink WI. Headache and neck pain in spontaneous internal carotid and vertebral artery dissections. Neurology 1995;45:1517-22.
12) Spalloni A, Ferrari M, Beccia M, Bracalello A, Rasura M. Bilateral spontaneous dissection of the internal carotid arteries. Eur J Neurol 2004;11:69-70.
13) Kwon SU, Koh JY, Kim JS. Vertebrobasilar artery territory infarction as an initial manifestation of systemic lupus erythematosus. Clin Neurol Neurosurg 1999;101:62-7.
14) Mitsias P, Levine SR. Large cerebral vessel occlusive disease in systemic lupus erythematosus. Neurology 1994;44(3 Pt 1):385-93.
15) Youl BD, Coutellier A, Dubois B, Leger JM, Bousser MG. Three cases of spontaneous extracranial vertebral artery dissection. Stroke 1990;21:618-25.
16) Sclair M, Nassar H, Bar-Ziv Y, Putterman C. Dissecting aortic aneurysm in systemic lupus erythematosus. Lupus 1995;4:71-4.