Subarachnoid and Intracerebral Hemorrhage in Patients with Churg-Strauss Syndrome: Two Case Reports

Abstract

Churg-Strauss syndrome (CSS) is a systemic necrotizing vasculitis of the small and medium vessels, associated with extravascular eosinophilic granulomas, peripheral eosinophilia, and asthma. The exact etiology of CSS is unknown. This syndrome commonly affects the lungs, peripheral nerves, skin, heart, and gastrointestinal tract, but rarely the central nervous system. Subarachnoid and intracerebral hemorrhage in CSS patients is extremely rare; however, clinicians should consider that CSS may be a cause of intracranial hemorrhage and its high rate of mortality and morbidity. The authors report on two cases of subarachnoid and intracerebral hemorrhage with CSS and discuss a brief review of CSS.

Demographic and Clinical Characteristics Associated with Central Nervous System Hemorrhage in Patients with Eosinophilic Granulomatosis with Polyangiitis: A Case Report and Review of the Literature

“…The most important limitation derives from the small number of cases analyzed. However, to our knowledge this is the largest series of patients with EGPA affected by CNS bleeding published in the literature 14,17 .…”

“…In these cases, cerebral ischemic infarction (~80%) and diffuse encephalopathy (~10%) have been by far the findings most frequently reported. Published data on EGPA with CNS hemorrhage are limited to anecdotal case reports [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]21,22,23,24,25,26 . We described a case of EGPA presenting with intracerebral hemorrhage (ICH) and did a comprehensive review of the literature.…”

Eosinophilic granulomatosis with polyangiitis: myocardial thickening reversed by corticosteroids

“…Notably, he had a cerebral hemorrhage, likely due to the presence of ischemic lesions in combination with antiplatelet therapy. Vasculitis affecting the central nervous system and leading to hemorrhagic stroke is uncommon in EGPA, but has been reported [ 9 – 11 ]. One case report also described concomitant vertebral artery dissection [ 11 ].…”

“…Vasculitis affecting the central nervous system and leading to hemorrhagic stroke is uncommon in EGPA, but has been reported [ 9 – 11 ]. One case report also described concomitant vertebral artery dissection [ 11 ]. The increase in serum creatinine lead to high suspicion of renal involvement and creatinine levels normalized after initiation of treatment.…”

Neurological disorders in eosinophilic granulomatosis with polyangiitis (Churg—Strauss syndrome)

“…Поражение ЦНС Поражение ЦНС при ЭГПА наблюдается у 10-15% больных [21,39] и преимущественно представлено тромбозами венозных синусов и нарушениями церебрального и спинального кровообращения ишемического и геморрагического характера [40,41]. У лиц с ЭГПА риск веноз-ных и артериальных осложнений выше, чем в среднем в популяции [42], и сосудистые осложнения могут развиваться в активную и неактивную стадии заболевания.…”