1/20. magnetic resonance angiography of primary varicella vasculitis: report of two cases.Two patients with onset of hemiparesis 3 weeks following primary varicella infection demonstrated contralateral temporal lobe and basal ganglia infarctions on magnetic resonance imaging. In both cases, magnetic resonance angiography (MRA) was performed and demonstrated flow abnormalities ipsilateral to the infarcts. Digital subtraction angiography was performed in one case; however, the findings were significantly less conspicuous than those of the MRA. MRA proved to be sensitive to the diagnosis of varicella-induced vasculitis in two consecutive cases and provided a noninvasive means of following the progression of the disease process in response to therapy.- - - - - - - - - - ranking = 1keywords = varicella (Clic here for more details about this article) |
2/20. Unilateral occlusion of the middle cerebral artery after varicella-zoster virus infection.We report a 4-year-old child who developed hemiplegia 6 months after varicella-zoster virus (VZV) infection. cerebral angiography showed complete occlusion of the right middle cerebral artery with basal moyamoya vessels. Elevation of anti-VZV antibody in the cerebrospinal fluid indicated central nervous system involvement. The association between VZV cerebral angitis and unilateral occlusion of right middle cerebral artery is discussed.- - - - - - - - - - ranking = 0.83333333333333keywords = varicella (Clic here for more details about this article) |
3/20. Hypercytokinemia in hemiconvulsions-hemiplegia syndrome associated with dual infection with varicella zoster and Epstein-Barr viruses.Hemiconvulsions-hemiplegia (HH) syndrome is an acquired condition in which hemiplegia develops after a preceding febrile unilateral status epilepticus in a previously healthy child. Although viral encephalitis or vascular diseases may be the underlying etiology, the pathogenesis remains unknown in the majority of cases. We measured both plasma and cerebrospinal fluid cytokine levels in a girl with HH syndrome, and found elevated plasma concentrations of soluble interleukin-2 receptor and tumor necrosis factor-alpha, and a slightly increased plasma level of interleukin-6. Furthermore, she had a high serum concentration of soluble e-selectin, which is a marker of inflammatory endothelial activation. These findings suggest that proinflammatory cytokine-induced cerebrovascular endothelial injury could play a role in the pathogenesis of HH syndrome.- - - - - - - - - - ranking = 0.66666666666667keywords = varicella (Clic here for more details about this article) |
4/20. Post-varicella arteriopathy: benefits of using serial transcranial Doppler examinations.A 2(8/12)-year old boy suffered from hemiplegia secondary to a post-varicella arteriopathy. His clinical status improved and after 4 years of follow-up he had no recurrent stroke or transient ischemic attack. Regular improvement of arterial lesions, demonstated by serial transcranial Doppler investigations, excluded a progressive arteriopathy. aspirin therapy was initiated and continued during 2,5 years. Transcranial Doppler is a portable, non-invasive tool that can be easily used on a regular basis to follow-up children with post-varicella arteriopathy.- - - - - - - - - - ranking = 1keywords = varicella (Clic here for more details about this article) |
5/20. Recurrent hemiplegia associated with cerebral vasculopathy following third trimester maternal herpes zoster infection.The chickenpox virus (varicella zoster virus; VZV) is known to cause large and small vessel central nervous system vasculopathies that may be associated with strokes in both adults and children. We present the case of a female aged 2 years 6 months who developed a chronic progressive small-vessel vasculopathy with radiological features of moyamoya disease as a manifestation of congenital varicella syndrome. Clinically, the condition was characterized by recurrent ischaemic strokes, which were brought under control using intravenous acyclovir. The case is unique in that it is the first report of congenital varicella syndrome to occur after a maternal herpes zoster infection. Furthermore, it is the first case of symptomatic VZV infection in a child to occur after a maternal infection occurring in the third trimester of pregnancy.- - - - - - - - - - ranking = 4.936864526357keywords = chickenpox, varicella (Clic here for more details about this article) |
6/20. Clinical features of vascular thrombosis following varicella.OBJECTIVE--To define the clinical characteristics, neuroimaging features, and outcome of five patients with post-primary varicella zoster virus infection hemiparesis and to offer a hypothesis to explain the predilection for the involvement of the cerebral vasculature in this condition. DESIGN--Patient series. SETTING--Five patients were treated during a 14-month period in a private pediatric neurology practice in a medium-size southwestern city. INTERVENTIONS--steroids (two patients) and antiplatelet drugs (two patients). No observed effects of therapy. RESULTS--The onset of the hemiparesis occurred several weeks (mean, 5.4 weeks) following an episode of the chickenpox. Magnetic resonance imaging was more sensitive than computed tomography or angiography in demonstrating the area of involvement deep in the cerebral hemispheres. The prognosis was good regardless of the therapy administered, as all patients recovered completely or nearly completely. CONCLUSIONS--Primary varicella zoster virus infection with delayed-onset hemiparesis typically occurs approximately 6 weeks after primary varicella zoster virus infection. magnetic resonance imaging is the most sensitive neuroimaging tool in these children. The prognosis is good, with recovery of function and no recurrences in our patients. The innervation of the carotid artery and the characteristics of the varicella zoster virus itself together provide the local and systemic factors that may trigger the vasculopathy responsible for this syndrome.- - - - - - - - - - ranking = 5.7701978596904keywords = chickenpox, varicella (Clic here for more details about this article) |
7/20. chickenpox pneumonia, its complications and management. A report of three cases, including the use of extracorporeal membrane oxygenation.We report three cases of chickenpox pneumonia in adults, all of whom required intermittent positive pressure ventilation. One patient developed a variety of complications, and another, a pregnant woman, required extracorporeal membrane oxygenation.- - - - - - - - - - ranking = 4.436864526357keywords = chickenpox (Clic here for more details about this article) |
8/20. Varicella with delayed contralateral hemiparesis detected by MRI.We report a 3 1/2-year-old boy who developed a hemiparesis 4 weeks after the onset of a varicella infection. In previously described cases of varicella with delayed contralateral hemiparesis, computed tomography typically revealed infarcts in the basal ganglia and internal capsule. To our knowledge, our patient is the first studied by magnetic resonance imaging. The pathogenesis of this syndrome may be a varicella zoster virus-related vasculopathy similar to that observed in herpes zoster ophthalmicus with delayed contralateral hemiparesis.- - - - - - - - - - ranking = 0.5keywords = varicella (Clic here for more details about this article) |
9/20. Varicella with delayed hemiplegia.We report 4 children who developed acute hemiplegia 7 weeks to 4 months after varicella infection. In 2 patients, carotid angiography demonstrated segmental narrowing and occlusion of the middle cerebral artery. Their clinical and angiographic features were similar to those associated with contralateral hemiplegia after herpes zoster ophthalmicus, the pathogenesis of which comprises cerebral angiitis due to varicella zoster viral infection. We believe that our patients had the same pathogenesis. In a survey of infectious diseases in our region, the frequency of varicella with delayed hemiparesis was roughly 1:6,500 varicella patients.- - - - - - - - - - ranking = 0.66666666666667keywords = varicella (Clic here for more details about this article) |
10/20. central nervous system vasculitis after chickenpox--cause or coincidence?A 7.5 year old boy, known to have a seizure disorder, presented with an infarct in the left middle cerebral artery territory, 10 weeks after severe chickenpox. Immunofluorescent antibody titre to the varicella zoster virus in the cerebrospinal fluid was 1:32. cerebral angiography showed evidence of focal vasculitis. He presented again seven months later with an acute exacerbation of seizures. magnetic resonance imaging of the brain showed an old posterior extension of the infarct, but a repeated angiography demonstrated an improvement in the vasculitic process. cerebrospinal fluid antibody titre was again 1:32. Although this may have been an unfortunate coincidence, a possible association between chickenpox and vasculitis, similar to that reported with herpes zoster, and with potentially significant clinical implications, should be considered. As a definite proof can be obtained only by a brain biopsy, however, which is generally not indicated in such cases, only additional clinical reports can lead to delineation of this association as a definite entity.- - - - - - - - - - ranking = 26.787853824809keywords = chickenpox, varicella (Clic here for more details about this article) |
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