Anaphylaxis-Associated Cerebral Infarction: A Case Report.

Area of Science:

• Neurology
• Immunology
• Allergy

Background:

• Anaphylaxis is a severe allergic reaction impacting respiratory and cardiovascular systems.
• Neurological complications, like cerebral infarction (stroke), are rare but serious sequelae of anaphylaxis.
• The exact mechanisms linking anaphylaxis to stroke are not fully understood, with limited case reports available.

Observation:

• A 75-year-old male with hypertension and diabetes experienced anaphylaxis post-bee sting, leading to quadriplegia.
• Neuroimaging confirmed bilateral middle cerebral artery (MCA) ischemic strokes, indicating hypoperfusion and endothelial dysfunction.
• The patient received standard anaphylaxis treatment and antiplatelet therapy for stroke prevention.

Findings:

• Anaphylaxis-induced hypoperfusion, endothelial dysfunction, and hypercoagulable states contribute to ischemic stroke.
• Cerebral infarction is a recognized, albeit uncommon, complication of anaphylaxis, especially in those with cerebrovascular risk factors.
• This case underscores the need for early neurological assessment and intervention in anaphylaxis.

Implications:

• Timely neuroimaging and hemodynamic stabilization are crucial for mitigating anaphylaxis-related brain ischemia.
• Understanding the multifaceted pathophysiology, including hypotension and inflammation, is key for effective stroke management in anaphylaxis.
• Multidisciplinary care and further research are essential for optimizing treatment strategies for anaphylaxis-associated stroke.