[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-421266-105":59,"doc-detail-421266-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","when-autoimmunity-and-vascular-events-collide-a-unique-presentation-of-hashimotos-encephalopathy-and-ischemic-stroke","When Autoimmunity and Vascular Events Collide - A Unique Presentation of Hashimoto’s Encephalopathy and Ischemic Stroke","","Hashimoto’s encephalopathy (HE) is characterized by diverse neurological and psychiatric manifestations, including cognitive decline, seizures, focal deficits, stroke-like events, psychosis, dementia, and coma, though its mechanisms remain incompletely understood. A 56-year-old woman with nodular thyroid disease and elevated antithyroid antibodies developed subacute encephalopathy, amnesia, and bilateral symmetric cerebral watershed ischemic strokes that improved with immunotherapy. The case highlights thyroid autoimmunity as a stroke risk context, discusses possible autoimmune, vasculitic, and hypoperfusion-related pathways, and emphasizes considering HE in acute stroke with thyroid disorders for timely treatment.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/when-autoimmunity-and-vascular-events-collide-a-unique-presentation-of-hashimotos-encephalopathy-and-ischemic-stroke/421266/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/when-autoimmunity-and-vascular-events-collide-a-unique-presentation-of-hashimotos-encephalopathy-and-ischemic-stroke/421266.png","ImageObject",300,407,{"name":92,"@type":93},"Riley","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What symptoms and clinical features define Hashimoto’s encephalopathy (HE) in this document?","Question",{"text":113,"@type":114},"HE is described as a condition with an umbrella of symptoms such as cognitive decline, seizures, neurological focal deficits, stroke, psychosis, dementia, and coma.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How did the patient’s thyroid condition and antibody status relate to the stroke presentation?",{"text":118,"@type":114},"The patient had nodular thyroid disease with elevated antithyroid antibodies and developed subacute encephalopathy with amnesia and bilateral symmetric watershed strokes, with clinical improvement after immunotherapy.",{"name":120,"@type":111,"acceptedAnswer":121},"Why is HE important to consider in patients with thyroid disease and acute stroke?",{"text":122,"@type":114},"Because HE has a low prevalence but a good steroid response, the document emphasizes that considering it as a differential diagnosis can enable prompt diagnosis and treatment.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},421266,1790766988,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},1374391975076,"https://ap-avatar.wpscdn.com/avatar/14000253ca4ec9f6853?x-image-process=image/resize,m_fixed,w_180,h_180&k=1783305029341752051","Review began 05/26/2025  \nReview ended 11/27/2025  \nPublished 12/03/2025  \n© Copyright 2025  \nCornejo Leon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98423  \nOpen Access Case Report  \nWhen Autoimmunity and Vascular Events Collide: A Unique Presentation of Hashimoto’s Encephalopathy and Ischemic Stroke  \nMarilhia C. Cornejo Leon 1, Nariman Noorbakhsh-Sabet 1  \n1. Department of Neurology, The University of Tennessee Health Science Center (UTHSC), Memphis, USA Corresponding author: Marilhia C. Cornejo Leon, [marilhiacor@gmail.com](marilhiacor@gmail.com)  \nAbstract  \nHashimoto’s encephalopathy (HE) encompasses an umbrella of symptoms, including cognitive decline, seizures, neurological focal deficits, stroke, psychosis, dementia, and coma. Its pathogenesis is not clear, nor is its mechanism by which it causes strokes.  \nA 56-year-old African American female with nodular thyroid disease presented with subacute encephalopathy, amnesia, and bilateral symmetric cerebral watershed strokes in the setting of elevated antithyroid antibodies that clinically improved after immunotherapy. This is a rare reported case of possible autoimmune thyroiditis (AT) presenting with watershed strokes.  \nThyroid disorders are a risk factor for cerebrovascular disease. Autoimmune thyroiditis increases the risk of stroke in patients with hypothyroid AT due to the higher frequency of atrial fibrillation, large artery atherosclerosis, and hypertension. The pathogenesis of HE is uncertain, but it is believed that it could be autoimmune, vasculitis, and/or hypoperfusion-related. Our patient had three episodes of hypotension, raising concern for global cerebral hypoperfusion due to the microvascular disruption that takes place in HE.  \nHE has a low prevalence but good response to steroids. Considering it as a differential diagnosis in cases of thyroid disease and acute stroke is crucial to promptly make a diagnosis and start treatment.  \nCategories: Neurology, Internal Medicine, Endocrinology/Diabetes/Metabolism  \nKeywords: autoimmune encephalopathy, autoimmune thyroid disorder, hashimoto’s encephalopathy, ischemic stroke, watershed stroke  \nIntroduction  \nHashimoto’s encephalopathy (HE) is an infrequent disease that can present with many of the common symptoms seen in hospital consultations. Learning about HE allows clinicians to consider it in the differential diagnosis of patients with cognitive decline, seizures, strokes, neurological focal deficits, dementia, and coma [1,2] . HE was initially described in 1966 as an acute or subacute encephalopathy or myelopathy associated with high serum levels of antithyroid antibodies (anti-thyroglobulin antibodies (antiTG) and antithyroid peroxidase antibodies (anti-TPO)), normal or abnormal thyroid function, and good response to corticosteroids [1] .  \nThe pathogenesis of HE is not fully understood, but evidence shows a possible autoimmune pathogenesis. An association with Hashimoto thyroiditis (HT) has been hypothesized [3] . However, research has shown that there is no correlation between disease activity and the titers of antibodies. Also, antithyroid antibodies are not specific indicators, as they may be elevated in 10% of the general population (anti-TPO at 11.3% and anti-TG at 10.4%) [4] .  \nAnother highlight of HE is that it is a classical example of a stroke chameleon. The mechanism by which HE causes stroke is not clear; case reports of HE have described strokes caused by autoimmune vasculitis [5,6], carotid atherosclerosis, atrial fibrillation, and hypoperfusion [7,8] .  \nWe report a case of encephalopathy, amnesia, and bilateral symmetric cerebral watershed strokes in the setting of elevated antithyroid antibodies, which clinically improved after immunotherapy. As far as we ","cbCaitNmgPJh9BO0","https://ap.wps.com/l/cbCaitNmgPJh9BO0","pdf",1055639,"English","# Abstract\n## Keywords\n# Introduction\n## Case Presentation","[{\"question\":\"What symptoms and clinical features define Hashimoto’s encephalopathy (HE) in this document?\",\"answer\":\"HE is described as a condition with an umbrella of symptoms such as cognitive decline, seizures, neurological focal deficits, stroke, psychosis, dementia, and coma.\"},{\"question\":\"How did the patient’s thyroid condition and antibody status relate to the stroke presentation?\",\"answer\":\"The patient had nodular thyroid disease with elevated antithyroid antibodies and developed subacute encephalopathy with amnesia and bilateral symmetric watershed strokes, with clinical improvement after immunotherapy.\"},{\"question\":\"Why is HE important to consider in patients with thyroid disease and acute stroke?\",\"answer\":\"Because HE has a low prevalence but a good steroid response, the document emphasizes that considering it as a differential diagnosis can enable prompt diagnosis and treatment.\"}]","When Autoimmunity and Vascular Events Collide - A Unique Presentation of Hashimoto’s Encephalopathy and Ischemic Stroke | PDF",1790624467,13]