{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:30:22Z","timestamp":1787495422084,"version":"build-2736575974"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare form of small\u2010vessel vasculitis typically associated with eosinophilia, asthma, and systemic inflammation. Although peripheral neuropathies are relatively common, central nervous system involvement, especially intracerebral hemorrhage during the remission phase of EGPA, is uncommon, and its clinical course and management remain poorly understood. The female patient had been diagnosed with EGPA 6\u2009months earlier based on marked eosinophilia of 16,380\/\u03bcL, late\u2010onset asthma, and mononeuritis multiplex, fulfilling the 2022 American College of Rheumatology\/European Alliance of Associations for Rheumatology classification criteria. After receiving high\u2010dose corticosteroids (Day\u2010165) and edoxaban for subacute distal deep vein thrombosis (Day\u2010158), her eosinophil count steadily decreased, and she was discharged without hypertension on oral prednisolone 40\u2009mg\/day (Day\u2010144). The dose was tapered to 13\u2009mg\/day without relapse. On Day 0, she developed acute left putaminal hemorrhage along with previous cerebral microbleeds on susceptibility\u2010weighted imaging (SWI) and an old, small brainstem infarction. Laboratory data showed a normal eosinophil count of 70\/\u03bcL and normal D\u2010dimer levels. Edoxaban was discontinued, and conservative management was initiated. Follow\u2010up ultrasound on Day 19 confirmed an organized thrombus without progression. She gradually improved with rehabilitation and achieved a modified Rankin Scale score of 1. Although mild sensory disturbance in the right upper and lower extremities persisted, she regained full independence in all activities of daily living and is currently working energetically as a bookstore clerk. She has remained stable for over 3.5\u2009years without anticoagulation or EGPA relapse. This case highlights that, although perhaps overlooked during the remission phase when clinicians may be less careful, intracerebral hemorrhage may occur even during EGPA remission, potentially owing to persistent small\u2010vessel endothelial vulnerability, which may elevate hemorrhagic risk even during clinical remission. The presence of microbleeds and prior infarction may reflect longstanding vascular injury, possibly exacerbated by anticoagulation. Current guidelines do not address this risk, underscoring the need for individualized risk assessment. This case may indicate that brain imaging, including SWI, could be considered prior to initiating anticoagulation therapy in patients with EGPA.<\/jats:p>","DOI":"10.1002\/ccr3.71944","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T12:00:42Z","timestamp":1769256042000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intracerebral Hemorrhage During the Chronic Phase of Eosinophilic Granulomatosis With Polyangiitis: A Case Report Emphasizing Cerebrovascular Vulnerability"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9953-8665","authenticated-orcid":false,"given":"Shinya","family":"Watanabe","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Mito Kyodo General Hospital, Tsukuba University Hospital Mito Area Medical Education Center  Mito Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Kasuya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Mito Kyodo General Hospital, Tsukuba University Hospital Mito Area Medical Education Center  Mito Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Shibata","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Mito Kyodo General Hospital, Tsukuba University Hospital Mito Area Medical Education Center  Mito Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,24]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584\u2010023\u201000958\u2010w"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.37715"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.37721"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2017.07.007"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102021\u2010221794"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.7461\/jcen.2012.14.3.255"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1994.01690090083012"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.04158\u20102020"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.7999\u201021"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2017.04.026"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.71944","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.71944","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.71944","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:23:07Z","timestamp":1772990587000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.71944"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,24]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/ccr3.71944"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.71944","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.22541\/au.175811468.80389487\/v1","asserted-by":"object"}]},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,24]]},"assertion":[{"value":"2025-09-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71944"}}