Neurologic symptoms are common in patients with the Churg-Strauss syndrome and often manifest as a peripheral neuropathy of the mononeuritis multiplex type secondary to vasculitis. Reports of central nervous system involvement is less frequent and ranges from psychiatric disturbances to cerebral hemorrhage. We report the first case of pathologically documented vasculitis involving the choroid plexus causing massive and fatal intraventricular and subarachnoid hemorrhages in a 47-year-old patient with Churg-Strauss syndrome.