Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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February 7, 2011
Varicella-Zoster Vasculitis and Stroke
- Multi-focal stroke is a rare complication of Varicella-zoster vasculitis (VZV). More commonly, vasculitis induced presentations include encephalitis, myelitis, ataxia, Reye syndrome, and Ramsay-Hunt syndrome.
- VZV usually occurs due to re-activation of the latent virus, affecting at risk population, which includes young children, elderly population, and immunocompromised patients.
- Small or large-sized arteries are involved. Typically, in the immunocompetent population, large-sized arteries are involved, while in the younger population, smaller-sized arteries are affected.
- Key Diagnostic Features: Patchy, confluent areas of signal abnormality in the white matter and multifocal areas of infarction.
- DDx: Other causes of vasculitis, encephalitis, demyelinating disease.
- Diagnosis: CSF analysis demonstrating anti-VZV IgG antibody, VZV DNA using PCR
- Rx: Acyclovir, steroids
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