Steroid-Responsive Cerebral Vasculitis in Systemic Lupus Erythematosus with Sulcal Hyperintensities

The clinical manifestations of cerebral lupus vasculitis have a wide spectrum severity which can result in different prognoses. Therefore, its diagnosis and treatment remain challenging without specific guidelines. A 49-year-old woman with systemic erythematosus presented transient left side paresthesia dysarthria lasting 20 minutes. Brain magnetic resonance imaging (MRI) showed multifocal diffusion restriction sulcal hyperintensities the right middle artery region. angiography (MRA) steno-occlusive lesions at her intracranial arteries. Because she only symptoms, aspirin (100 mg/day), atorvastatin (20 mg/day) an increased dose prednisolone (5 mg/day to 10 were started, on suspicion vasculitis. MRIs/MRAs renormalized after four months any recurrence. Cerebral manifests diverse neuroimaging characteristics. Although brain image demonstrates devastating features, tailored immune therapy should be selected based patient’s symptoms.