J Cerebrovasc Endovasc Neurosurg.  2012 Sep;14(3):255-261. 10.7461/jcen.2012.14.3.255.

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

• Go MH
• Park JU
• Kang JG
• Lim YC

• KMID: 1808466
• DOI: http://doi.org/10.7461/jcen.2012.14.3.255

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.

Keyword

Churg-Strauss syndrome; Intracerebral hemorrhages; Subarachnoid hemorrhage

MeSH Terms

Asthma
Central Nervous System
Cerebral Hemorrhage
Churg-Strauss Syndrome
Eosinophilia
Eosinophilic Granuloma
Gastrointestinal Tract
Heart
Humans
Intracranial Hemorrhages
Lung
Peripheral Nerves
Skin
Subarachnoid Hemorrhage
Vasculitis

Figure

• 

  Fig. 1 Brain three dimensional computed tomography (3D CT) angiography. Brain CT showed a thick subarachnoid hemorrhage, including in peri-medullary cistern (A). Brain CTA revealed a left-sided vertebral artery dissection (VAD) and aplasia on the contra-lateral side VA (B).

• 

  Fig. 2 Cerebral angiography. Digital subtraction angiography (DSA) image demonstrates an extravasation of the contrast media form dissected segment (A). Postembolization angiography demonstrates complete occlusion of the segment of the extravasation and the flow of the dominant left VA was preserved (B).

• 

  Fig. 3 Preoperative brain CT shows a large amount of intracerebral hemorrhage in the right basal ganglia (A). Postoperative brain CT at three days after surgery reveals reduction of the hematoma (B).

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