Extraosseous Epidural Multiple Myeloma

Churg-Strauss Syndrome is a rare, systemic granulomatous disorder resulting in a necrotizing vasculitis affecting the small and medium-sized vessels. We present the exceedingly rare occurrence of a patient with known Churg-Strauss Syndrome presenting with large occipitoparietal intraparenchymal hemorrhage requiring neurosurgical evacuation and management. Neurosurgical evacuation of ICH provides both diagnostic and therapeutic utility in the setting of CNS vasculitis. Further, this case demonstrates that a combined approach with neurosurgery, immunosuppressive and anti-inflammatory therapy can provide excellent outcomes in patients presenting with ICH and CSS.