Background
Ischemic stroke is a rare complication of Churg–Strauss syndrome (CSS) and its pathogenesis
has not been well clarified yet. We report a case of cerebral infarction in a patient
with CSS due to embolism from a thrombus on the wall of the aorta.
Case
A 39-year-old man had multiple cerebral infarctions with symptoms of mild left hemiparesis
and reduced vision. He was clinically diagnosed to have CSS based on remarkable eosinophilia,
history of asthma, sinusitis, pulmonary infiltrates, and histologically proven extravascular
eosinophilic infiltrates in the specimen of gastric mucosa. Cerebral angiography did
not show any stenotic lesions in cerebral arteries. A thrombus was detected on the
wall of the aorta by transesophageal echocardiography, which was considered as the
source of embolism. The thrombus resolved on follow-up examination 3 months after
the onset of the stroke.
Conclusions
This is the first case report on cerebral infarction caused by aortogenic thromboembolism
in a CSS patient. Other than cerebral vasculitis, embolism from cardiovascular system,
including the wall of the aorta, is a possible cause of cerebral infarctions in a
CSS patient.
Key Words
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References
- The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis).Arthritis Rheum. 1990; 33: 1094-1100
- Vasculitis of the central nervous system.J Neurol. 1998; 245: 766-776
- Multiple cerebral infarctions in a patient with Churg-Strauss syndrome.J Neurol. 2010; 257: 678-680
- A case of Churg-Strauss syndrome presenting with cortical blindness.Clin Rheumatol. 2000; 19: 318-320
- Churg-Strauss syndrome with concomitant occurrence of ischemic stroke and relapsing purpura.J Stroke Cerebrovasc Dis. 2012; 21 (e9-e10): 911
- Showered cortical infarctions and brain atrophy in Churg-Strauss syndrome.Eur Neurol. 2011; 65: 112
- Churg-Strauss syndrome as an unusual aetiology of stroke with haemorrhagic transformation in a patient with no cardiovascular risk factors.Case Rep Neurol. 2011; 3: 32-38
- Multimodality assessment of cardiac involvement in Churg-Strauss syndrome patients in clinical remission.Circ J. 2011; 75: 649-655
- Acute myocardial infarction caused by a floating thrombus in the proximal ascending aorta.Korean J Intern Med. 2015; 30: 921-924
- Clinical utility of cardiac magnetic resonance imaging in Churg-Strauss syndrome: case report and review of the literature.Rheumatol Int. 2009; 29: 445-449
- Cardiac magnetic resonance imaging in Churg-Strauss syndrome. Impact of immuno suppressants on outcome assessed in a prospective study on 8 patients.Clin Exp Rheumatol. 2010; 28: 8-13
Article info
Publication history
Published online: December 16, 2016
Accepted:
October 31,
2016
Received in revised form:
October 18,
2016
Received:
May 26,
2015
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.10.042
Copyright
© 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
