Systemic lupus erythematosus complicated with cerebral venous sinus thrombosis: A report of two cases

A rare manifestation of systemic lupus erythematosus (SLE) is cerebral veno us sinus thrombosis (CVST), in which early diagnosis and aggressive therapy are of prime importance for favorable outcome. The pathogenesis of CVST is largely unknown, but it is thought to be caused by cerebral vasculitis, an tiphospholipid antibodies or other conditions associated with enhanced coag ulability. We describe two cases of SLE with CVST which were not associated with antiphospholipid antibodies. Both cases were treated with immunosuppr essants (intravenous methylprednisolone and cyclophosphamide pulse therapy) and anticoagulant drugs (heparin and subsequent maintenance therapy with w arfarin). There was a marked improvement of neurologic symptoms with the di sappearance of thrombus in a follow-up MRI. The possibility of CVST should be considered in any patients with SLE who show neuropsychiatric manifestat ions.