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Calcific cerebral embolism in systemic calciphylaxis
G Katsamakis1, T G Lukovits, P B Gorelick
1Department of Neurological Sciences, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612-3824, USA.
Insights
Calciphylaxis, a rare complication of end-stage renal disease, can affect the brain. This case highlights calciphylaxis leading to mitral annular calcification and a stroke due to a calcified cerebral embolus.
Area of Science:
- Nephrology
- Cardiology
- Neurology
Background:
- Calciphylaxis is a rare, severe complication in patients with end-stage renal disease (ESRD) and hyperparathyroidism.
- It involves calcification of small blood vessels, leading to tissue ischemia and necrosis.
Observation:
- A 26-year-old woman with chronic renal failure and systemic calciphylaxis presented with new-onset neurological deficits.
- Imaging revealed mitral annular calcification and a right middle cerebral artery (MCA) stroke.
Findings:
- The stroke was attributed to a calcified cerebral embolus.
- The probable source of the embolus was identified as the mitral valve, indicating a link between mitral annular calcification and cerebral events in calciphylaxis.
Implications:
- This case underscores the potential for calciphylaxis to cause significant cerebrovascular complications.
- It highlights the importance of considering cardiac valvular calcification as a source of embolic events in patients with calciphylaxis.
- Further research may explore screening strategies for cardiac involvement in calciphylaxis patients to prevent such events.
Abstract:
Calciphylaxis represents a rare complication of end-stage renal disease with hyperparathyroidism. We report the case of a 26-year-old woman with systemic calciphylaxis secondary to chronic renal failure who developed mitral annular calcification and a right middle cerebral artery stroke. The high-density lesion seen on CT scan of the brain probably represents a calcified cerebral embolus originating from the mitral valve.