[Ischemic stroke secondary to post varicella angiopathy in a 3 year old male]

Ischemic cerebrovascular disease is an infrequent problem in the paediatric age, but one which we now understand better thanks to modern neuroimaging techniques. We know little about its aetiopathogenesis, which is very varied, and it has been reported as being associated with viral infections such as chicken pox.

A male, aged 3 years, who presented sudden hemiparesis, facial paralysis and dysarthria, without any other accompanying neurological symptoms. The patient had suffered a bout of chicken pox 6 weeks earlier. Of the abnormal complementary explorations, the most notable were varicella positive serological tests and MRI and MR angiography that pointed to ischemic involvement of the cortex. The patient progressed very well and the clinical features had completely reverted at five weeks.

Post varicella angiopathy is one of the acquired risk factors for an ischemic stroke, and has been claimed to account for up to a third of all strokes in infants. Neuroimaging techniques allow the topographic determination of the ischemic repercussions. Patients usually progress well and in most cases the clinical features completely revert within a short time. We conclude that chicken pox should be included in the vaccination schedule as soon as possible in order to prevent complications that, as in the case we have reported, can be very serious.