A wide variety of conditions have been reported in association with SLE. Note that true cerebral vasculitis has been documented in SLE but is very uncommon (10, 11). An example of an uncommon condition associated with SLE, severe cerebral calcinosis, is illustrated in Figure 10. Calcification in the basal ganglia has been reported in SLE at a higher incidence than in the general population, and in fewer cases, the cerebral cortex, cerebral white matter, thalamus, cerebellum, and brain stem are involved (12, 13).

A.		B.
C.		D.
E.		F.

Figure 10. Cerebral calcinosis. A 56-year-old man had a ten year history of very active, severe SLE. His neurologic course included gait disturbance, hyperreflexia, dysarthria, and cognitive deterioration. CT scans performed before his death documented severe, widespread calcifications including brain stem, deep gray matter, cortex, and cerebellum (A, B). These findings on CT did not significantly change over eight years. An autopsy was performed. Gross photographs of the cerebellum (C) and thalami (D) show dense concretions. Extensive perivascular calcifications are visible on photomicrograph of the cerebral cortex (E, x160, H & E stain). Radiography with magnification (i.e., mammography technique) was performed on a coronal slice at the level of the thalami (F) and showed fine, radiating calcifications in a vascular pattern in addition to the dense "stones" in the thalami. Histologic examination of the brain showed perivascular calcifications but no evidence of vasculitis.