Cerebral Kounis Syndrome—a rare case report of cerebral vasospasm following anaphylaxis

Ismail, Mohd Helmie and Muniandy, Sadesvaran and Azmi, MUhammad Shafiq (2026) Cerebral Kounis Syndrome—a rare case report of cerebral vasospasm following anaphylaxis. Clinical Practice and Cases in Emergency Medicine, 10 (3). pp. 291-294. ISSN 2474252X

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Abstract

Introduction: Kounis syndrome describes anaphylaxis-induced coronary vasospasm and is often misdiagnosed as acute coronary syndrome. We report a similar phenomenon of cerebral vasospasm following anaphylaxis, a rare and under-recognized mimic of stroke. Case Report: A previously healthy 45-year-old gentleman developed sudden right-sided hemiparesis and dysarthria while working outdoors, accompanied by generalized pruritus, rash, presyncope, dyspnea, palpitation, and abdominal pain. He received prompt intramuscular epinephrine and other anti-inflammatory agents, resulting in rapid symptom resolution and complete recovery in the emergency department. Computed tomography of the brain and other studies were unremarkable. This case underscores a rare neurological manifestation of anaphylaxis. Conclusion: Cerebral vasospasm is an unusual sequela of anaphylaxis that may lead to a diagnostic dilemma. Prompt administration of epinephrine is crucial for recovery. This case highlights the association between hypersensitivity reactions and cerebrovascular events, emphasizing the need for early recognition and timely intervention. [Clin Pract Cases Emerg Med. 2026;10(3):291–294.]

Item Type:	Article (Case Report)
Uncontrolled Keywords:	Keywords: cerebral vasospasm; anaphylaxis; Kounis syndrome; case report.
Subjects:	R Medicine > R Medicine (General) R Medicine > RC Internal medicine > RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Emergency Medicine
Depositing User:	Dr Mohd Helmie Ismail
Date Deposited:	03 Sep 2026 22:04
Last Update:	03 Sep 2026 22:04
Queue Number:	2026-08-Q4972
URI:	http://irep.iium.edu.my/id/eprint/130888
Indexed In:	SCOPUS, Google Scholar

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