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Stroke, Vol 17, 753-754, Copyright © 1986 by American Heart Association

ARTICLES

Sudden hemiparesis as the presenting sign in cryptococcal meningoencephalitis

RF Saul, JG Gallagher and JE Mateer

A previously healthy young man presented with an acute stroke syndrome and was found to have cryptococcal organisms in the CSF. Though an initial CSF examination for an infectious etiology was negative, a second lumbar puncture was performed because of hypoglycorrhachia, which established the diagnosis. An uneventful recovery followed the administration of Amphotericin B and 5-Flucytosine. A literature search revealed only one previously reported case of cryptococcal meningoencephalitis presenting as a stroke. The need for performing a CSF examination on young patients presenting with a cerebrovascular event, and the aggressive investigation of unexplained hypoglycorrhachia are emphasized.