Stroke after varicella and zoster ophthalmicus: another indication for treatment and immunization.

摘要

In this issue of the Journal, Ciccone et al present a review of 70 cases of stroke after varicella and zoster infection in children. The median age was 5 years, with a range of 6 months to 11 years. The median interval between varicella-zoster virus (VZV) infection and stroke was 18 weeks, although 1 patient manifested a stroke during the incubation period of chickenpox. Angiography showed involvement of the middle cerebral artery, anterior cerebral artery, and internal carotid artery in decreasing order. Imaging by magnetic resonance imaging demonstrated infarcts within the brain. More than 50% had permanent sequelae.The majority of the 70 reports have been published in the past 20 years. In 1994, Grose reviewed all the published literature on the complications of varicella infection in children. Although neurologic complications were the subject of many reports during the earlier century, stroke was rarely mentioned. However, hemiparesis and hemiplegia were specifically described by Underwood in his superb review in 1935, but obviously lacked the imaging technology currently available to define a stroke after VZV infection. Thus, the most likely reason for the emergence of more case reports of stroke after varicella in the last 2 decades is the amazing improvement in radiology and magnetic resonance imaging.