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An unusual case of stroke

Michael Rosario1, Sarah Xianyuan Song, Louise D McCullough

  • 1Department of Neurology, University of Connecticut Health Center, The Stroke Center, Hartford, CT 06030, USA.

The Neurologist
|June 28, 2012
PubMed

Insights

A rare case of multiple strokes in both anterior and posterior circulation was caused by Cryptococcus, a fungal infection. Early diagnosis of this unusual cause of vasculitis is crucial, especially when fever is absent.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Advanced neuroimaging enables swift and precise stroke diagnosis.
  • Central nervous system vasculitis is a potential cause of stroke.

Observation:

  • A 58-year-old woman presented with multiple large vessel strokes identified via magnetic resonance imaging.
  • Initial investigations suggested rapidly progressive central nervous system vasculitis.

Findings:

  • Further workup identified an uncommon infectious cause: cryptococcal meningitis.
  • This is the first reported instance of multiple anterior and posterior circulation strokes attributed to Cryptococcus.

Implications:

  • Fungal infections like cryptococcal meningitis can lead to vasculitis and stroke.
  • Delayed diagnosis is common in encephalopathy cases without fever, highlighting the need for broader differential diagnoses.

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