Post Varicella Angiopathy as a Cause of Pediatric Stroke: A Case Report

Abstract

Varicella-zoster virus is a neurotropic herpes virus that contains double stranded DNA. It can cause primary, latent and reactivation infection. Chickenpox is the primary manifestation and result in life long latent infection of sensory neurons. Varicella infection is usually self limiting and complications occur mostly in immunocompromised patients. The most common neurological complications following varicella infection are cerebellar ataxia and encephalitis but arterial ischemic stroke in pediatric patient is also significant. Post varicella angiopathy also published under transient cerebral arteriopathy and is nearly always self -limited and may be the result of focal inflammation1. Arterial ischemic stroke may occur during the course of varicella infection or one week to several months after the appearance of rash. Here we present a case of 6 years old male who presented with right hemiparesis with right sided facial nerve palsy two months after chickenpox. An MRI was done which was suggestive of hyperintensities in basal ganglia and internal capsule in T-1 weighted MRI. Although the weakness was self-limiting patient was treated with aspirin in addition to supportive measures. Keywords: Arterial ischemic stroke, Post varicella angiopathy, Varicella zoster virus, Middle cerebral artery, Upper motor neuron, Lower motor neuron.