Systemic lupus erythematosus flare up as acute spinal subarachnoid hemorrhage with bilateral lower limb paralysis

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Xiang Yang(1), Seidu A. Richard(2), Jiagang Liu(3*), Siqing Huang(4)

1 Department of Neurosurgery, West China Hospital, Sichuan University, China.
2 Department of Neurosurgery, West China Hospital, Sichuan University, P.R China; Department of Immunology, Jiangsu University, Jiangsu, P.R. China; Department of Surgery, Volta Regional Hospital, Ho, Ghana, Ghana.
3 Department of Neurosurgery, West China Hospital, Sichuan University, China.
4 Department of Neurosurgery, West China Hospital, Sichuan University, China.
(*) Corresponding Author:
Jiagang Liu
neurovip@yeah.net

Abstract

Subarachnoid hemorrhage (SAH) is an uncommon complication of systemic lupus erythematosus (SLE). Solitary association of fatal spinal SAH as a complication of SLE, has not been encountered much in literature although coexisting acute cerebral and spinal SAH have been associated with SLE. We present a 39-year old female with initial diagnosis of SLE eight years ago who suddenly developed a productive cough, acute abdomen and paralysis of the lower limbs. Magnetic resonance imaging of the spine revealed thoracic spinal SAH with varying degrees of thoracic spinal cord compression. The hemorrhage was total evacuated via surgery. She regained normal function of her lower limbers after the operation with no further neurological complications. One of the rare but fatal complications of SLE is solitary spinal SAH without cranial involvement. The best and most appropriate management of this kind of presentation is surgical decompression of the hematoma with total hemostasis. The cause of hemorrhage should be identified intra-operatively and treated appropriately.


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How to Cite
Yang, X., Richard, S., Liu, J., & Huang, S. (2018). Systemic lupus erythematosus flare up as acute spinal subarachnoid hemorrhage with bilateral lower limb paralysis. Clinics and Practice, 8(2). https://doi.org/10.4081/cp.2018.1069