[Sequential change of cerebral angiography in a case of cerebral angiitis following herpes zoster ophthalmicus].
Delayed neurological symptoms and signs following herpes zoster ophthalmicus (HZO) such as "Delayed contralateral hemiplegia with HZO" are supposed to be due to ipsilateral intracranial angiitis and ischemic disorder. We experienced a rare case with ipsilateral cerebral hemorrhage following HZO. Under the diagnosis of cerebral angiitis associated with HZO, we treated her conservatively and observed sequential change of angiography for four months. A 54-year-old female, who had been treated for systemic lupus erythematosus (SLE), developed HZO on left ophthalmic nerve area. Seven weeks after the onset of HZO, she complained of headache, mild right hemiparesis, and disturbance of consciousness. Computed tomography revealed subcortical hemorrhage at the left temporo-occipital lobe. Cerebral angiography showed vascular irregularities such as segmental narrowing and sausage-like dilation on proximal portion of the ipsilateral anterior, middle and posterior cerebral arteries. Same findings were seen on peripheral portions of the posterior cerebral artery on the same side. Moreover sequential angiograms showed appearance of an aneurysm in the left middle cerebral artery (M2 potion). Under the diagnosis of cerebral angiitis associated with HZO, she was treated with antiviral agents, antiplatelet drugs, steroid and stellate ganglion block. Those irregularities were found to diminish on the sequential angiograms, and the aneurysm disappeared four month later.
Tomiyama
N
N
Department of Neurosurgery, University of Ryukyus School of Medicine, Okinawa, Japan.
Mukawa
J
J
Yamashiro
K
K
Kinjo
T
T
Momoji
J
J
Arakaki
H
H
Nagataki
S
S
D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D006563:Herpes Zoster Ophthalmicus / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014657:Vasculitis / Q000000981:diagnostic imaging* / Q000209:etiology*