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Central nervous system vasculitis after chickenpox--cause or coincidence?
A Shuper1, E P Vining, J M Freeman
1Department of Neurology, Johns Hopkins Medical Institution, Baltimore, MD 21205.
Archives of Disease in Childhood
|November 1, 1990
Summary
Chickenpox (varicella-zoster virus) may be associated with childhood stroke due to vasculitis. Further clinical reports are needed to confirm this link, as brain biopsy is usually not indicated.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- A 7.5-year-old boy with a seizure disorder developed a stroke in the left middle cerebral artery territory.
- The stroke occurred 10 weeks after a severe case of chickenpox.
Observation:
- Cerebrospinal fluid showed elevated antibodies to varicella-zoster virus (1:32).
- Cerebral angiography revealed focal vasculitis.
- The patient experienced a seizure exacerbation seven months later.
- Follow-up angiography indicated improvement in the vasculitic process.
Findings:
- The case suggests a potential association between chickenpox and vasculitis leading to stroke in children.
- Elevated varicella-zoster virus antibody titers in CSF support a possible viral trigger.
Implications:
- This association, if confirmed, has significant clinical implications for pediatric neurology and infectious disease management.
- Further case reports are crucial for establishing this link, as brain biopsy is often contraindicated.