title: Cerebrovascular disease and varicella in children.
abstract: Varicella-associated stroke has been reported with increasing frequency in recent years. In many cases, diagnosis is difficult because of the late onset of manifestations after the acute infectious episode. Four cases of cerebrovascular disease after varicella infection were observed. Three children presented hemiparesis and one facial paresis. The neuroradiological findings comprised stenosis/occlusion of middle cerebral artery or nucleo capsular signal alteration. Because, several pathogenetic mechanisms have been proposed as the cause of stroke, the relationship between prothrombotic conditions, antipospholipid antibodies and stroke in these patients is discussed. The difficulty in defining the pathogenesis of the ischemic episode is related to problems in the choice of antithrombotic treatment, which is still not standardized and must be decided on individual basis. In the event of rapid onset of stroke after exanthem high dose antiviral therapy seems to be justified. On the basis of our experience and of literature data on varicella-associated stroke, we recommend that VZV infection be taken into account in every episode of stroke in children.
authors.affiliation: Infectious Diseases Unit, G. Gaslini Children's Hospital, Largo G. Gaslini 5, 16147 Genoa, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Losurdo
authors.forename: Raffaella
authors.initials: R
authors.lastname: Giacchino
authors.forename: Elio
authors.initials: E
authors.lastname: Castagnola
authors.forename: Marco
authors.initials: M
authors.lastname: Gattorno
authors.forename: Simona
authors.initials: S
authors.lastname: Costabel
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.forename: Stefano
authors.initials: S
authors.lastname: Amato
authors.forename: Pasquale
authors.initials: P
authors.lastname: Di Pietro
authors.forename: Angelo Claudio
authors.initials: AC
authors.lastname: Molinari
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000097:blood; D002533:Cerebral Angiography; D002648:Child; D002675:Child, Preschool; D020804:Encephalitis, Varicella Zoster / Q000150:complications* / Q000276:immunology / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020521:Stroke / Q000276:immunology / Q000473:pathology* / Q000821:virology*
chemical_list: D017152:Antibodies, Antiphospholipid