Ischemic stroke complicated by intracerebral hemorrhage in patients with hypereosinophilic syndrome: a case series

Patients with hypereosinophilic syndrome (HES) suffer from thrombotic events including ischemic stroke. Simultaneous occurrence of stroke and intracerebral hemorrhage (ICH) in such patients have rarely been reported. Here, we describe two patients with HES who suffered from ischemic stroke complicated by ICH. In case 1, we used a recombinant tissue plasminogen activator for acute ischemic stroke without treating hypereosinophilia; consequently, ICH occurred. In case 2, the patient had an ischemic stroke and ICH upon admission. In both cases, we used glucocorticoids to control hypereosinophilia, and no additional ischemic stroke or ICH occurrence was observed. These cases suggest that patients with HES can experience both ischemic and hemorrhagic strokes simultaneously and emphasize the importance of early control of eosinophilia to reduce the risk of cerebrovascular complications.