Cerebral Infarction Diagnosed as Isolated Cardiac Sarcoidosis.

Abstract

Cardiac sarcoidosis elicits cardiac disorders due to granuloma formation in cardiac tissue; it can lead to cerebral infarcts. We encountered a 72-year-old Japanese male with isolated cardiac sarcoidosis diagnosed after a cardiogenic cerebral infarction. He suffered a sudden-onset disturbance of consciousness, aphasia, and right hemiparesis. His National Institutes of Health Stroke Scale score was 17. The diagnosis was left middle cerebral artery occlusion due to cardiogenic embolism. Percutaneous thrombectomy achieved thrombolysis and recanalization of the cerebral infarction; his National Institutes of Health Stroke Scale score improved to 0. Cardiac ultrasonography revealed an enlarged left atrial diameter, a thinned inferior ventricular wall, a ventricular aneurysm, and left ventricular systolic dysfunction. During the clinical course, ventricular tachycardia was noted; sarcoidosis was suspected as the underlying disease. As no definitive diagnosis could be made, he was discharged on the 54th day of hospitalization. 18F-fluorodeoxyglucose positron emission tomography in the outpatient department showed localized abnormal accumulation in the left ventricle, and he was diagnosed with isolated cardiac sarcoidosis. Steroid treatment was added to anticoagulation therapy. There have been no recurrent cerebral infarctions or lesions in other organs. Cardiac sarcoidosis can be 1 cause of cardiogenic cerebral infarction.