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Hypercalcaemia associated with cerebral vasospasm causing infarction

G L Walker, P M Williamson, R B Ravich

    Journal of Neurology, Neurosurgery, and Psychiatry
    |May 1, 1980
    PubMed
    Summary
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    High calcium levels from vitamin D issues can cause brain artery spasms, leading to rare strokes. This study highlights cerebral arterial spasm as a potential cause of neurological damage in hypercalcemia.

    Area of Science:

    • Neurology
    • Endocrinology
    • Vascular Medicine

    Background:

    • Central nervous system (CNS) disorders are frequently observed in patients with hyperparathyroidism and hypercalcemia.
    • While neuropsychiatric disturbances are common, acute encephalopathies and seizures can also manifest.
    • Cerebral infarction represents a rare but serious neurological complication.

    Observation:

    • This report details a patient with neuroradiological evidence of cerebral infarction.
    • The infarction was attributed to cerebral arterial spasm.
    • The arterial spasm was linked to hypercalcemia resulting from hypervitaminosis D.

    Findings:

    • Hypercalcemia, particularly due to vitamin D toxicity, can induce cerebral arterial spasm.
    • Cerebral arterial spasm is identified as a potential etiological factor in focal neurological deficits associated with high calcium levels.

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  • This mechanism offers a novel explanation for stroke in specific hypercalcemic conditions.

    • Implications:

    • Recognizing cerebral arterial spasm in hypercalcemic patients is crucial for accurate diagnosis and timely intervention.
    • Understanding this mechanism may lead to targeted therapies to prevent stroke in individuals with hyperparathyroidism and vitamin D toxicity.
    • This finding expands the differential diagnosis of stroke, emphasizing the importance of metabolic evaluation.