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Postvaricella angiopathy: report of a case with pathologic correlation
M Hayman1, G Hendson, K J Poskitt
1Division of Neurology, Department of Pediatrics, University of British Columbia, Vancouver, BC, V6H 3V4, Canada.
Pediatric Neurology
|August 23, 2001
Summary
Varicella can cause delayed central nervous system complications like stroke. This case highlights post-varicella angiopathy affecting blood vessels, leading to severe brain infarction and herniation.
Area of Science:
- Neurology
- Pediatrics
- Pathology
Background:
- Varicella (chickenpox) is a common viral illness in children.
- Central nervous system complications of varicella are frequent.
- Delayed post-varicella angiopathy is a rare but serious complication.
Observation:
- A 4-year-old boy presented with extensive stroke in the right middle cerebral artery (MCA) territory, two months after varicella.
- Cerebral angiography revealed significant stenosis of the right proximal MCA.
- The patient developed refractory cerebral edema, progressing to transtentorial herniation.
Findings:
- Pathologic examination showed small vessel vasculitis with lymphocytic infiltration.
- Demyelination was observed in the white matter.
- Polymerase chain reaction for varicella on brain tissue was negative.
Implications:
- Post-varicella angiopathy can affect both small and large cerebral blood vessels.
- This condition can lead to catastrophic neurological outcomes, including stroke and brain herniation.
- Clinicopathologic correlation is crucial for understanding and managing this rare complication.