Guillain-Barré Syndrome and Cerebral Hemorrhage: Two Cases and Literature Review

Abstract

Aims: The study aimed to investigate the potential relationships between Guillain-Barré syndrome (GBS) and cerebral hemorrhage. Methods: Two patients diagnosed with hemorrhagic stroke and GBS were reported. More specifically, the sequential occurrence and the corresponding mechanisms of these 2 diseases were analyzed. Results: Two patients with cerebral hemorrhagic stroke developed progressive flaccid quadriplegia and life-threatening dyspnea in acute stage. Combined with the cerebrospinal fluid and electromyogram results, they were diagnosed as having acute GBS. It was found that GBS and cerebral nervous system (CNS) hemorrhage can occur successively, but the different sequences of occurrence had completely different pathogeneses. GBS following CNS hemorrhage was found to be related to the imbalance of systemic inflammatory responses, whereas CNS hemorrhage following GBS was due to blood vessel autonomous dysfunction and the use of immunoglobulin intravenously. Both groups of patients had only good prognoses when they were intensively observed. Conclusions: Despite being rare, GBS complicated with CNS hemorrhage deserves more attention due to its notable impact.

Two cases of Guillain-Barré syndrome after cerebral hemorrhage or head trauma

“…[2] In recent years, weakness of extremities and weakened, or even loss of, tendon reflexes have been reported in some patients with traumatic brain injury, cerebral hemorrhage, spinal cord injury, brachial plexus injury, or pelvic fracture fixation. [3][4][5][6] In this article, we provide detailed clinical data of two patients who were diagnosed with GBS following brain hemorrhage or craniocerebral injury. The diagnosis of our 2 patients is based on the diagnostic criteria of GBS published in 2014, which was modified according to the criteria published in 1990.…”

Subarachnoid hemorrhage due to de novo dissecting vertebral artery aneurysm in a patient with Guillain‐Barré syndrome

“…Due to such autonomic dysfunction, hypertension, reversible cerebral vasoconstriction, and intracerebral hemorrhage are induced . On the other hand, as complications of immunoglobulin (IVIg), SAH and reversible cerebral vessel contraction syndrome were reported . In our patient, IVIg was intravenously administered before the onset of SAH.…”

Fulminant Guillain–Barré Syndrome and Spontaneous Intraventricular Hemorrhage: A Case Report and Literature Review

“…In our case, the patient presented with GBS after spontaneous intraventricular hemorrhage. There are also a few cases that have reported that GBS can be caused by head trauma, neurosurgery, or other cerebral hemorrhagic injury ( Rivas et al, 2008 ; Yardimci et al, 2009 ; Tan et al, 2010 ; Song et al, 2012 ; Mantero et al, 2013 ; Zhang and Li, 2014 ; Wu et al, 2016 ; Li et al, 2017 ). Table 1 reviews the GBS cases that have developed after cerebral hemorrhagic injury (CHI).…”

“…Moreover, there are some GBS cases that have been described before CHI ( Table 2 ; Gande et al, 1999 ; Doss-Esper et al, 2005 ; Chang et al, 2014 ; Wei et al, 2015 ). Some of the possible mechanisms of GBS after CHI are the acute inflammation triggered by hemoglobin infiltration, disturbance of cellular humoral immunity after brain injury, and the stress state after hemorrhage ( Wu et al, 2016 ). However, the molecular mechanism leading to GBS is still unclear.…”