Focal cerebral vasculitis and stroke after chickenpox

Eur J Paediatr Neurol. 2002;6(6):331-3. doi: 10.1016/s1090-3798(02)90622-7.

Abstract

Cerebral infarcts are rather rare in children and can be caused by a number of diverse conditions. We report a case of cerebral infarct associated with a recent varicella infection. A 5-year old girl presented with an acute central facial palsy 1 month after a chickenpox infection. The infarction was revealed by magnetic resonance imaging and laboratory studies ruled out all known causes of stroke. Cerebral angiogram demonstrated segmental narrowing and irregularity of the wall of the right internal carotid artery, compatible with focal vasculitis. With the presumed diagnosis of varicella-associated focal angiitis, the patient was treated with high-dose methylprednisolone, acyclovir and aspirin. Magnetic resonance angiogram performed 6 weeks after the stroke demonstrated the resolution of the vasculitis. Varicella infection should be considered one of the possible causes of acute ischaemic strokes in children.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Brain / blood supply
  • Brain / microbiology*
  • Brain / pathology
  • Carotid Arteries / diagnostic imaging
  • Carotid Arteries / pathology
  • Cerebral Angiography
  • Chickenpox / complications*
  • Chickenpox / drug therapy
  • Chickenpox / virology*
  • Child, Preschool
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Methylprednisolone / therapeutic use
  • Stroke / diagnosis
  • Stroke / etiology*
  • Vasculitis, Central Nervous System / drug therapy
  • Vasculitis, Central Nervous System / etiology*
  • Vasculitis, Central Nervous System / virology*

Substances

  • Anti-Inflammatory Agents
  • Antiviral Agents
  • Acyclovir
  • Methylprednisolone