Abstract
We present a 73 year-old Japanese woman with localized scleroderma involving the right
side of the scalp accompanied by continuous tingling pain, who developed insidiously
progressive left hemiparesis. In magnetic resonance imaging of the brain, an infarct
first appeared in the watershed region of the right middle cerebral artery territory
and subsequently extended to deep white matter accompanied by scattered hemorrhages.
Focal stenosis in the M2 portion of the right middle cerebral artery was revealed
on magnetic resonance angiography, and the distal vessels were only shown faintly.
A biopsy specimen from the sclerotic scalp lesion showed obvious thickening of vessel
walls and mild mononuclear cell infiltration. We believe that the progressing ischemic
stroke was caused by hemodynamic disturbances from localized sclerotic obstruction
of the middle cerebral artery, with an autoimmune pathogenesis.
Keywords
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Article info
Publication history
Accepted:
August 14,
1998
Received in revised form:
August 14,
1998
Received:
March 30,
1998
Identification
Copyright
© 1999 Elsevier Science B.V. Published by Elsevier Inc. All rights reserved.
