Isolated cerebellar stroke in a paediatric patient with typical haemolytic uraemic syndrome: a case report and literature review

Neuroradiology. 2024 Oct;66(10):1859-1865. doi: 10.1007/s00234-024-03407-x. Epub 2024 Jun 26.

Abstract

Haemolytic Uraemic Syndrome (HUS) is a rare medical condition characterised by microangiopathic haemolytic anaemia, thrombocytopenia, and acute kidney injury. Neurological complications are documented but rarely involve the cerebellum. We present a unique case of a 23-month-old male with HUS triggered by Escherichia coli-O157 (E.coli-O157) infection leading to an isolated cerebellar stroke.The patient initially presented with fever, bloody stools, and seizures. Confirmation of E.coli-O157 infection was obtained, and MRI revealed an isolated cerebellar stroke. Treatment included supportive care, anticoagulation for a right atrial thrombus, with gradual improvement observed.This case highlights the unusual occurrence of isolated cerebellar stroke in HUS patients, emphasising the importance of promptly recognizing manifestations of the central nervous system and the necessity for a multidisciplinary approach. Finally, a comprehensive literature review was conducted to identify cases of HUS patients with cerebellar involvement.

Keywords: 1Cerebellum; 2Posterior-Inferior Cerebellar Artery; 3PICA; 4HUS; 5Case report; 6Ischaemic injury.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cerebellar Diseases / diagnostic imaging
  • Cerebellar Diseases / etiology
  • Diagnosis, Differential
  • Escherichia coli Infections / complications
  • Escherichia coli Infections / diagnostic imaging
  • Escherichia coli O157
  • Hemolytic-Uremic Syndrome* / complications
  • Hemolytic-Uremic Syndrome* / diagnostic imaging
  • Hemolytic-Uremic Syndrome* / therapy
  • Humans
  • Infant
  • Magnetic Resonance Imaging / methods
  • Male
  • Stroke / diagnostic imaging
  • Stroke / etiology