Postvaricella angiopathy: report of a case with pathologic correlation

Hayman, Michael; Hendson, Glenda; Poskitt, Kenneth J; Connolly, Mary B

« Previous Next »Pediatric Neurology
Volume 24, Issue 5 , Pages 387-389, May 2001

Postvaricella angiopathy: report of a case with pathologic correlation

Presented in part at the 34^th Annual Meeting of the Canadian Congress of Neurological Sciences, Edmonton, Canada, June 1999.

Michael Hayman, MB, BS
- Division of Neurology, Department of Pediatrics; University of British Columbia; British Columbia’s Children’s Hospital; Vancouver, Canada
Glenda Hendson, MB, BCh
- Division of Pathology, Department of Pediatrics; University of British Columbia; British Columbia’s Children’s Hospital; Vancouver, Canada
Kenneth J Poskitt, MD
- Division of Radiology, Department of Pediatrics; University of British Columbia; British Columbia’s Children’s Hospital; Vancouver, Canada
Mary B Connolly, MB
- Division of Neurology, Department of Pediatrics; University of British Columbia; British Columbia’s Children’s Hospital; Vancouver, Canada
- Communications should be addressed to: Dr. Connolly; Division of Neurology; British Columbia’s Children’s Hospital; 4480 Oak Street; Vancouver, BC, V6H 3V4, Canada

Received 1 July 1999; accepted 14 February 2001.

Abstract

Varicella is a common childhood illness, and central nervous system complications occur frequently. Delayed angiopathy has been described, although there are few reports of clinicopathologic correlation. A previously well 4-year-old male is presented. He suffered varicella 2 months before presentation with extensive right middle cerebral artery (MCA) territory infarction. Cerebral angiography demonstrated an isolated 89% stenosis of the right proximal MCA. He developed cerebral edema refractory to medical treatment and progressed to transtentorial herniation. Right frontal temporoparietal craniotomies were performed with evacuation of infarcted brain tissue. Pathologic studies revealed small vessel vasculitis with lymphocytic infiltration of the vessel wall. Areas of demyelination were present within the white matter. Polymerase chain reaction for varicella was negative on brain tissue. Postvaricella angiopathy, although an uncommon complication, may affect both small and large blood vessels, with catastrophic results.