Clinical Reasoning: A 26-Year-Old Woman With Headache and Eosinophilia.

Goh, Wilson Guo Wei; Ng, Isaac Kah Siang; Tan, Marcus Kai Xuan; Fong, Clare Yoke Kum; Chua, Christopher Yuan Kit; Yan, Gabriel Zherong; Chavatte, Jean-Marc; Soon, Derek Tuck Loong et al. · Neurology · 2025

case_report · Level V

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Abstract

Headache accompanied by eosinophilia in blood or CSF presents a complex clinical challenge. We present a case of a 26-year-old woman with headache, peripheral eosinophilia with meningeal enhancement, and intracranial vasculopathy on imaging. This case illustrates a systematic approach to a patient with meningitis, peripheral eosinophilia, and cerebral vasculitis, which includes comprehensive clinical history taking and appropriate investigative workup to differentiate between infectious and noninfectious causes and timely tissue sampling to conclusively determine the causative agent.

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