CNS Involvement in Hypereosinophilic Syndrome

CNS involvement in hypereosinophilic syndrome is very rare, postulated to be related to either a prothrombotic state or concomitant endomyocardial fibrosis. Imaging findings demonstrate infarcts with a penchant for a border zone distribution, exemplified by this case. Identifying hypereosinophilia as the underlying cause for these infarcts can have tremendous clinical implications for guiding the work-up and for swiftly initiating the appropriate therapy to minimize further end organ damage.