Hypereosinophilic syndrome with recurrent strokes: a case report

Hypereosinophilic syndrome is a rare disorder which can cause ischemic stroke. Although cardioembolism is acknowledged as the most common etiology for stroke, the underlying pathogenesis of hypereosinophilic syndrome could be heterogeneous. Herein we describe a patient with persistent hypereosnophillia with recurrent strokes focusing on the pathogenetic mechanism of stroke.

A 43-year-old male patient with persistent primary eosinophilia presented with ischemic stroke which persisted for three weeks. Magnetic resonance imaging showed bilateral multiple cerebral infarctions over both anterior and posterior vascular territories. Segmental stenosis of the right posterior cerebral artery was revealed with magnetic resonance angiography and computed tomography angiography. Extensive laboratory workup ruled out other etiologies for the strokes except eosinophilia, which responded well to corticosteroid therapy.

Cerebrovascular wall damage inflicted by eosinophilia may be the pathogenesis of the thromboembolic strokes in this case.