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Two cases of persistent anastomoses between the carotid and vertebrobasilar systems which have only once been previously reported are described. These are a proatlantal intersegmental artery which arises from the external carotid artery and a primitive trigeminal artery with direct anastomosis to the superior cerebellar artery. Angiographic criteria for differentiation of the proatlantal and more common hypoglossal arteries, as well as the rare persistent cervical intersegmental artery are also presented.

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Summary. The authors describe three young women with systemic lupus erythematosus and hemiparesis who had major cerebral artery stenosis or occlusion documened by angiography. The only four similar, previously reported cases are reviewed; none of these have been published in the radiologic literature. In two of these seven patients middle cerebral artery stenosis progressed to complete occlusion. Supraclinoid internal carotid artery occlusions were demonstrated in the other five cases. Systemic lupus erythematosus should therefore be a primary diagnostic consideration in young women with intracranial internal carotid artery occlusion. Demonstration angiographique de l'oeclusion ma]eure de vaisseaux cerebraux en cas de lupus erithemateux systemariseRdsumd. Les auteurs rapportent le cas de trois jeunes femmes pr4sentant un lupus 6rithdmateux syst4matis4 et une h4mipar4sie, chez qui l'angiographie montra une stdnose ou une occlusion majeure des art~res c4rdbrales.Les auteurs font la revue des seuls quatre cas antTrieurs analogues dent aucun n'avait 6t6 publi6 duns la littTrature radiologique. Chez deux de ces sept roulades la stTnose de l'artTre cTrTbrale moyerme progressa jusqu'~ l'oeelusion eomplTte. Duns les cinq autres cas, on trouva des oeelusions de l'artTre earotide interne supra-clino/diennes. Le lupus 6rithTmateux systTmatis6 devrait donc @tre 6voqu6 eomme premiTre considTration diagnostique chez des jeunes femmes prTsentant une occlusion de l'artTre earotide interne. Angiographischer Nachweis yon grSfleren cerebralen Gefdflverschlfessen beim Lupus erythematodesZusammenfassung. Die Autoren beschreiben 3 jiingere Frauen, bei denen ein Lupus erythematodes vorlag. Bei diescn Patientinnen bestand gleichzeitig eine Hemiparese, undes konnte angiographisch ein intracranieller Gef~13-verschlul~ nachgewiesen werden. Diese Gef/ii?verschliisse beim Lupus erythematodes sind sehr selten und bisher in der radiologischen Literatur noch nicht publiziert.Signs and symptoms referable to the nervous system have been reported in 28 [3] --75% [26] of patients with systemic lupus erythematosus (SLE). Itemiplegia or focal cerebral dysfunction is reported in as many as 5% of these patients [8]. The neurologic deficits have been ascribed to a variety of lesions, most commonly arteritis of small vessels [17,26,29,35]. It is our purpose to review the problem of major vessel occlusion in systemic lupus erythematosus and to present three patients in whom this was visualized angiographically. There are no previous reports in the radiologic literature which demonstrate these findings in SLE. Case Reports Case ISystemic lupus erythematosus appeared in this white woman at age 20. The initial manifestation was a malar rash and thrombophlcbitis. Lupus erythematosus (LE) cells were isolated on this occasion. Her symptoms eompletly subsided with small doses of prednisone. During the next year she became pregnant and a severe generalized rash erupted. After a spontaneous abortion, the rash ameliorated and it was possible to start tapering the l...