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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
Summary
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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