Hémiballisme vasculaire révélant une hépatite C avec cryoglobulinémie

Central nervous system involvement has rarely been described in patients with hepatitis C and cryoglobulinemia. Few cases have been described in the literature. Moreover, the mechanism by which lesions are produced in the central nervous system is still not clear. We describe the case of a 62-year-old man who presented with sudden onset of hemiballism on the left side of his body. Cerebral magnetic resonance showed small ischemic lesions involving the thalamus, brainstem, and the periventricular white matter suggesting cerebral vasculitis. Laboratory evaluation revealed a positive hepatitis C virus and a high level of serum cryoglobulin. The cardiovascular check-up was normal. We can conclude that a cerebrovascular accident may have been the initial clinical presentation of the hepatitis C virus and mixed type II cryoglobulinemia. HVC serologic tests and cryoglobulinemia should be considered in patients with cerebral ischemia of undetermined aetiology.