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Stroke, Vol 24, 473-475, Copyright © 1993 by American Heart Association

ARTICLES

Fulminant cerebral infarctions with membranous nephropathy

S Chaturvedi
Department of Neurology, University of Massachusetts Medical Center, Boston.

BACKGROUND: Arterial thromboses, including cerebral infarction, are a rare complication of the nephrotic syndrome. SUMMARY OF REPORT: A 37- year-old woman presented with right upper extremity ischemia, left middle cerebral artery thrombosis, and right cerebellar infarction. She quickly herniated, and postmortem evaluation revealed membranous nephropathy. Increased fibrinogen and decreased free protein S levels were noted. CONCLUSIONS: Membranous nephropathy can lead to rapidly progressive cerebral infarctions, with possible fatality. There is not a unifying hematologic explanation for the strokes seen with nephrotic syndrome.