1. Vasculitis.
Vasculitis. This 16-year-old girl with systemic lupus erythematosus, chronic pancreatitis, nephritis, hypertension, cerebritis, and epilepsy presented with a 2-day history of chest pain and headache and a seizure on the day of admission. She was hypertensive and treated with methylprednisolone (Solu-Medrol) and cyclophosphamide (Cytoxan). Her complete blood count and chemistry profiles were normal, and she had no evidence of acute infection. Axial CT (A), FLAIR (B), and SWI (C and D) images are shown. A small hemorrhage is present in the right frontal lobe (arrows) on CT (A) and SWI (C). However, only the SWI images demonstrate numerous additional tiny hypointense foci suggestive of petechial hemorrhages or possibly microthrombi throughout the white matter, particularly within the corpus callosum and internal capsules. She was placed on a higher dose steroid regimen and discharged 1 week after admission. Although the etiology of the lesions was undetermined, vasculitis or Cytoxan therapy were considered as possibilities.
K.A. Tong et al. AJNR Am J Neuroradiol 2008;29:9-17
©2008 by American Society of Neuroradiology