Cerebrovascular Complications After Adult-Onset Varicella-Zoster Virus Encephalitis in the Central Nervous System: A Literature Review release_mufppbq73bh3zdsb3w4wpdtahq

by Wu H, Wang R, Li Y, Sun X, Li J, Bi X

Published in Neuropsychiatric Disease and Treatment by Dove Medical Press.

2022   Volume Volume 18, p449-462

Abstract

Hangfei Wu,* Ruoru Wang,* Yuanyuan Li, Xu Sun, Jiasi Li, Xiaoying Bi Department of Neurology, Shanghai Changhai Hospital, Shanghai, People's Republic of China*These authors contributed equally to this workCorrespondence: Xiaoying Bi; Jiasi Li, Department of Neurology, Shanghai Changhai Hospital, No. 168, Changhai Road, Yangpu District, Shanghai, 200433, People's Republic of China, Email bixiaoying2013@163.com; lijiasisissi@163.comBackground: Cerebrovascular complications after adult-onset varicella-zoster virus (VZV) encephalitis have been increasingly recognized. The aim of this study was to analyze clinical and neuroimaging findings, treatment and outcome of these patients.Methods: Literature review from January 2000 to December 2019. We searched for studies published in PubMed, Embase and Chinese Biomedical Literature Database. Clinical symptoms, neuroimaging findings, treatment and outcome were evaluated.Results: We analyzed 31 articles with a total of adult-onset 34 cases, including 25 cases of ischemic stroke, 6 of intracerebral hemorrhage and 3 with venous sinus thrombosis. Ischemic stroke was the major complication after VZV encephalitis accounting of 73.35%. There were more males than females in ischemia or venous sinus thrombosis groups. The middle-aged was prone to cerebral infarction, the elderly was for cerebral hemorrhage, and the young was for venous sinus thrombosis. Cognitive impairment was the most common symptom either in the ischemic group or hemorrhagic group. The lesions of VZV-associated cerebral infarction or hemorrhage were multifocal and mostly involved in the parietal lobe, followed by frontal or temporal lobes. Venous sinus thrombosis was common in the transverse sinus. Multiple stenosis of the anterior and posterior circulation vessels was found. A 60.87% of the patients with antiviral treatment in the ischemic group had favorable prognosis. All patients with anticoagulant therapy in venous sinus thrombosis group improved well; however, 60% of the patients with intracerebral hemorrhag [...]
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