Dissection of the posterior inferior cerebellar artery in the hypereosinophilic syndrome

Gaalen, Judith van; Dijk, Ewout J. van; Deuren, Marcel van; Leeuw, Frank Erik de

doi:10.1007/s00415-011-6089-7

Cited by 8 publications

(4 citation statements)

References 12 publications

(15 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Radiological and histological findings. Overall, the radiologic findings included an irregular enhancement of the brain parenchyma (27), infarction due to arterial dissection (69) and intracerebral hemorrhage on a computerized tomography scan (32,52), multiple arterial narrowing on angiography (52), ischemic lesions in multiple brain areas (case #6), T2/FLAIR hyperintense lesions with gadolinium enhancement on T1-weighted magnetic resonance imaging MRI (32,56,70,81). In the four cases of isolated cerebral vasculitis, the blood AEC was normal; eosinophilia in the cerebrospinal fluid was found in only one case (32), and the diagnosis required a brain biopsy in all cases.…”

Section: Central Nervous Systemmentioning

confidence: 99%

“…Fifteen patients developed other typical clinical manifestations of HES, such as skin lesions (variously described as reddish plaques, erythema, swelling, erythematous papules, subcutaneous nodules, skin rashes, etc.) (48,69,83,84) (personal cases #9 and 10), eosinophilic fasciitis (52,69), arterial thrombosis (in the brain or the digestive tract) (34,46), liver nodules and/or dysfunction (35,57), spleen enlargement and/or infiltration by eosinophils (23,69,74), eosinophilic colitis (83) (case #9), eosinophilic meningoencephalitis (case #7), inflammatory white matter lesions (case #8), and eosinophilic myositis (personal case #8). Biopsies were collected in the great majority of these cases but no features of EoV were found.…”

Section: Other Non-vasculitic Manifestations Associated With Eovmentioning

confidence: 99%

See 1 more Smart Citation

“Idiopathic Eosinophilic Vasculitis”: Another Side of Hypereosinophilic Syndrome? A Comprehensive Analysis of 117 Cases in Asthma-Free Patients

Lefèvre

Leurs

Gibier

et al. 2020

The Journal of Allergy and Clinical Immunology: In Practice

View full text Add to dashboard Cite

Section: Central Nervous Systemmentioning

confidence: 99%

Section: Other Non-vasculitic Manifestations Associated With Eovmentioning

confidence: 99%

“Idiopathic Eosinophilic Vasculitis”: Another Side of Hypereosinophilic Syndrome? A Comprehensive Analysis of 117 Cases in Asthma-Free Patients

Lefèvre

Leurs

Gibier

et al. 2020

The Journal of Allergy and Clinical Immunology: In Practice

View full text Add to dashboard Cite

“…Our literature review identified three other cases of severe vascular complications occurring in L-HES patients, either as unique case reports ( 5 – 6 ) or among complications mentioned in a L-HES patient cohort ( 7 ) ( Supplementary Table S1 ).…”

Section: Resultsmentioning

confidence: 99%

Case report: Serious unexpected vascular events in two patients with lymphocytic variant hypereosinophilic syndrome

Torcida,

Casalino,

Bondue

et al. 2023

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundLymphocytic-variant hypereosinophilic syndrome (L-HES) is a form of reactive hypereosinophilia, most commonly associated with interleukin-5 over-production by clonal, most commonly CD3−CD4+CD2hiCD5hiCD45RO+ T-cells. Patients often present with predominant cutaneous and soft-tissue manifestations, while cardiovascular involvement is uncommon.MethodsWe reviewed the medical files of two L-HES patients followed in our center who developed serious vascular complications and performed a literature review for similar cases.ResultsPatient 1, a 52-year-old female, presented with an ischemic stroke secondary to left middle cerebral artery dissection after 10 years of indolent L-HES. Blood eosinophilia was controlled with oral corticosteroids (OCS), but OCS-tapering attempts with hydroxyurea and pegylated interferon failed, prompting the introduction of mepolizumab with rapid normalization. Patient 2, a 62-year-old female, had been asymptomatic for 10 years without treatment when a NSTEMI occurred, due to coronary artery occlusion secondary to a large cauliflower-aneurysm of the proximal aorta and aneurysmal dilatation of several coronary arteries, requiring semi-urgent surgical management. Aortic wall staining for eosinophil major basic protein showed eosinophils in the adventitia. Blood eosinophilia was controlled with OCS.ConclusionsPatients with apparently clinically benign L-HES may develop arterial complications, consisting in dissection and/or aneurysm dilatation of medium-to-large vessels with serious consequences. The value of performing regular vascular imaging and monitoring during follow-up has yet to be determined.

show abstract

“…We searched PubMed to identify case reports of stroke with HES and found 97 cases that have been reported from January 2000 to October 2021 [2] , [4] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , …”

Section: Introductionmentioning

confidence: 99%

Literature reviews of stroke with hypereosinophilic syndrome

Ono

Iwahana

Kato

et al. 2021

IJC Heart & Vasculature

View full text Add to dashboard Cite

Hypereosinophilic syndrome (HES) is defined by persistently elevated blood eosinophil levels and is associated with evidence of organ damage. Cardiovascular involvement in HES is most commonly associated with Loffler endocarditis (cardiac HES). Cardiac HES is typically characterized by progressive subendocardial fibrosis with overlying mural thrombus formation, leading to restrictive dysfunction of the left ventricle. The thrombus from cardiac HES could result in cardiogenic stroke; however, most of the stroke cases with HES were not associated with huge thromboembolism rather multiple infarcts in the watershed area. The major clinical features of 97 previously reported cases of stroke with HES are as follows: the median age was 52 years, of which 61 (63%) were men; the initial presenting symptoms were neurological (73%), followed by headache (16%), respiratory symptoms (9%), and visual symptoms (9%). Almost half of the cases were diagnosed with cardiac HES. The characteristics of cardiac findings were mural thrombi, endomyocardial fibrosis, and a restrictive pattern of heart failure. Cerebral findings revealed 78 cases (80%) were described as multiple infarctions and 55 cases (57 %) were involved with watershed areas, whereas 11 cases (11％) were described as embolic stroke for one proximal large-vessel occlusion. Regarding treatment, 71 (73%), 28 (29%), and 16 (16%) patients were treated with steroids, anticoagulants, and antiplatelets, respectively. The overall mortality and recovery rates were 11% and 89%, respectively. Physicians should know most cases of stroke with HES are characterized by multiple infarctions in the watershed area, and cardiac HES is not always associated with stroke.

show abstract

Dissection of the posterior inferior cerebellar artery in the hypereosinophilic syndrome

Cited by 8 publications

References 12 publications

“Idiopathic Eosinophilic Vasculitis”: Another Side of Hypereosinophilic Syndrome? A Comprehensive Analysis of 117 Cases in Asthma-Free Patients

“Idiopathic Eosinophilic Vasculitis”: Another Side of Hypereosinophilic Syndrome? A Comprehensive Analysis of 117 Cases in Asthma-Free Patients

Case report: Serious unexpected vascular events in two patients with lymphocytic variant hypereosinophilic syndrome

Literature reviews of stroke with hypereosinophilic syndrome

Contact Info

Product

Resources

About