Cerebral vascular accident during the recovery phase of hemolytic uremic syndrome.

The hemolytic uremic syndrome (HUS) of children is characterized by microangiopathic hemolytic anemia and acute renal failure. Although a wide spectrum of neurologic symptoms are commonly observed in patients with HUS, the pathogenesis of the central nervous system (CNS) impairment of HUS is often unclear. Microthrombi of cerebral vessels similar to those demonstrated in the kidneys have been reported. The neurologic manifestations generally occur during the early and active phase of the disease. We report a 4 year old boy with HUS who suddenly developed a dense hemiplegia subsequent to hematological and a marked nephrological recovery. The child's cranial axial tomography scan demonstrated a large area of infarction in the region of the right basal ganglia. Follow up examination eight weeks after insult revealed a distinct neurologic recovery with mild loss of fine motor function of the left hand and weakness of the left leg.