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Cerebral Arteriolar Thromboembolism in Idiopathic Hypereosinophilic Syndrome
Journal article   Open access   Peer reviewed

Cerebral Arteriolar Thromboembolism in Idiopathic Hypereosinophilic Syndrome

Mikayel Grigoryan, Scott D Geisler, Erik K. St Louis, Gary L Baumbach and Patricia H Davis
Archives of neurology (Chicago), Vol.66(4), pp.528-531
2009
DOI: 10.1001/archneurol.2009.36
PMID: 19364940
url
https://doi.org/10.1001/archneurol.2009.36View
Published (Version of record) Open Access

Abstract

Objective: To describe imaging findings as well as postmortem brain and cardiac pathology in a patient with fulminant idiopathic hypereosinophilic syndrome. Design: Case report. Setting: University hospital. Patient: A 48-year-old right-handed man with hypereosinophilia, rapidly progressive encephalopathy, and focal neurological deficits who died 22 days after presentation. Main outcome measures: Physical examination, radiologic, and neuropathologic examination results. Results: Imaging of the brain revealed bihemispheric ischemic changes in and beyond the watershed distributions. Pathology review demonstrated mural cardiac thrombus that likely caused cardioembolism as well as diffuse microangiopathy despite resolution of the hypereosinophilia. Conclusions: Timely recognition of idiopathic hypereosinophilic syndrome may enable aggressive treatment prior to widespread cardioembolism and degranulation that result in devastating cerebrovascular complications.
Neurology Biological and medical sciences Medical sciences Vascular diseases and vascular malformations of the nervous system

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