What is the role of echocardiography and ultrasonography in the workup of CNS lupus?

Updated: May 04, 2021
  • Author: Pradeep C Bollu, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

When embolic stroke occurs in patients with proven or suspected systemic lupus erythematosus (SLE), echocardiography is mandatory to assess for valvular and other intracardiac lesions. In the patient known to have SLE who presents with an apparently nonembolic stroke syndrome or apparent so-called focal cerebritis, cardiac emboli remain the most likely etiology, mandating echocardiography in these settings as well. Transesophageal echocardiography may be helpful in selected cases.

In one study, strokes and leukoaraiosis were more common in the group with antiphospholipid syndrome (APLS) than in the group without APLS, which is consistent with the idea of an APLS-induced prothrombotic state. [39]

The carotid bifurcation may be conveniently imaged by ultrasonography.

As noted previously, magnetic resonance angiography (MRA) can confirm thrombotic lesions of extracranial or intracranial vessels in systemic lupus erythematosus (SLE), as can transcranial Doppler ultrasonography.


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