Type of publication:
Conference abstract
Author(s):
European Stroke Journal. Conference: 10th European Stroke Organisation Conference Abstracts. Basel Switzerland. 9(1 Supplement) (pp 499), 2024. Date of Publication: 01 May 2024.
Citation:
*Kondalkar K.; *Craik S.; *Osineye B.; *Srinivasan M.
Abstract:
Background and aims: Varicella zoster is a documented risk factor for development of ischemic stroke for up to 1 year following infection. Multiple cases of stroke following zoster reactivation have been reported previously. Here we outline two admissions to our ward in 2023 in which a stroke developed following primary zoster infection. Method(s): An 18 year old woman was admitted with right hand numbness, speech disturbance and headache. A CT angiogram revealed occlusion of the left middle cerebral artery. She was treated with dual antiplatelets. A lumbar puncture was performed and cerebrospinal fluid was positive for Varicella zoster. On further history the patient revealed she had chicken pox 3 months prior. She was treated with intravenous aciclovir and discharged with her neurological symptoms largely resolved. Result(s): A 75 year old male with a background of Non-Hodgkin lymphoma was admitted with acute confusion and right sided weakness and high fever. Examination also revealed a rash to the torso and head. CT revealed an area of low attenuation in the right basal ganglia, MRI revealed multiple bilateral infarctions. Lumbar puncture was performed due to suspected encephalitis and PCR was positive for Varicella zoster. The patient was treated with intravenous aciclovir however suffered a drop in consiousness. A repeat CT revealed catastrophic intracerebral bleed extending into the ventricles. The patient received palliative care and died one day later. Conclusion(s): Varicella zoster infection is an important risk factor for stroke in both younger and older adults and should be considered in unusual presentations.
DOI: 10.1177/23969873241245672
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