Acute progressive stroke with middle cerebral artery occlusion caused by idiopathic hypereosinophilic syndrome: a case report

摘要

Hypereosinophilia with massive cerebral infarction and middle cerebral artery (MCA) occlusion in a 55-year-old woman. Onset Stage: a Diffusion-weighted magnetic resonance imaging (DWI) revealed multiple acute infarcts in right hemisphere. b Coronal enhanced MRI revealed bilateral middle cerebral artery wall thickening and enhancement (red arrows). c MRA showed slightly stenosis in horizontal segment of right MCA. Progression Stage: d DWI revealed new cerebral infarction in left hemisphere. e CTP showed a significantly longer peak time (TTP) in both hemispheres. f DSA showed M1 segment of left MCA occlusion. After endovascular therapy, partial MCA recanalization g. Recovery Stage: Brain flair MRI h demonstrated focal ischemia changes. i Follow-up brain MRA showed bilateral middle artery branches occlusion