Document Detail


Cerebral arteriolar thromboembolism in idiopathic hypereosinophilic syndrome.
MedLine Citation:
PMID:  19364940     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Mikayel Grigoryan; Scott D Geisler; Erik K St Louis; Gary L Baumbach; Patricia H Davis
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Archives of neurology     Volume:  66     ISSN:  1538-3687     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-14     Completed Date:  2009-04-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  528-31     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242, USA. mikayel-grigoryan@uiowa.edu
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MeSH Terms
Descriptor/Qualifier:
Anterior Cerebral Artery / pathology
Arterioles / pathology
Bone Marrow / pathology
Brain / pathology
Diagnosis, Differential
Diffusion Magnetic Resonance Imaging*
Dominance, Cerebral / physiology
Echocardiography, Transesophageal
Endocardium / pathology
Fatal Outcome
Heart Diseases / complications,  diagnosis,  pathology
Humans
Hypereosinophilic Syndrome / complications*,  diagnosis,  pathology
Image Processing, Computer-Assisted*
Infarction, Anterior Cerebral Artery / diagnosis*,  pathology
Male
Middle Aged
Thrombosis / complications,  diagnosis,  pathology
Tomography, X-Ray Computed*

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