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NEUROLOGY 1990;40:99
© 1990 American Academy of Neurology

Cerebral blood flow variations in CNS lupus

M. J. Kushner, MD, M. Tobin, MD, F. Fazekas, MD, J. Chawluk, MD, D. Jamieson, MD, B. Freundlich, MD, S. Grenell, MD, L. Freemen, MD and M. Reivich, MD

Cerebrovascular Research Center, Department of Neurology (Drs. Kushner, Fazekas, Chawluk, Jamieson, and Reivich), and the Department of Medicine (Dr. Freundlich), University of Pennsylvania Medical Center, Philadelphia, PA; and the Montefiore Hospital Medical Center (Drs. Tobin, Grenell, and Freemen), Bronx, NY.

We studied the patterns of cerebral blood flow (CBF), over time, in patients with systemic lupus erythematosus and varying neurologic manifestations including headache, stroke, psychosis, and encephalopathy. For 20 paired xenon-133 CBF measurements, CBF was normal during CNS remissions, regardless of the symptoms. CBF was significantly depressed during CNS exacerbations. The magnitude of change in CBF varied with the neurologic syndrome. CBF was least affected in patients with nonspecific symptoms such as headache or malaise, whereas patients with encephalopathy or psychosis exhibited the greatest reductions in CBF. In 1 patient with affective psychosis, without clinical or CT evidence of cerebral ischemia, serial SPECT studies showed resolution of multifocal cerebral perfusion defects which paralleled clinical recovery.

Address correspondence and reprint requests to Dr. Michael J, Kushner, Cerebrovascular Research Center, Room 429 Johnson Pavilion, 36th and Hamilton Walk, University of Pennsylvania, Philadelphia, PA 19104.

Dr. Kushner is the recipient of Clinical Investigator Development Award 1 K08 NS00999-05.

Received April 4, 1989. Accepted for publication in final form June 23, 1989.




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