An atypical case of post-varicella stroke in a child presenting with hemichorea followed by late-onset inflammatory focal cerebral arteriopathy

Bertamino, Marta; Signa, Sara; Vagelli, Giulia; Caorsi, Roberta; Zanetti, Alice; Volpi, Stefano; Losurdo, Giuseppe; Amico, Giulia; Dodi, Icilio; Prato, Giulia; Ronchetti, Anna; Rocco, Maja Di; Nagel, Maria A.; Severino, Mariasavina

doi:10.21037/qims-20-628

Cited by 6 publications

(2 citation statements)

References 42 publications

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“…Infectious agents known to be responsible for focal arteriopathy are Varicella‐zoster virus, herpes viruses, HIV, parvovirus B19, influenza A, enteroviruses, and Mycoplasmia pneumoniae . The delay between initial infection and neurologic symptoms can be long, 18 sometimes around 6 months. The clinical presentation is various.…”

Section: Discussionmentioning

confidence: 99%

Ischemic stroke on SARS‐CoV2 vasculitis in a healthy young girl

Petat

Hassani

Dabaj

et al. 2023

Health Science Reports

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Background and Aims In France, we noted the fifth wave of SARS‐CoV2 pandemic, characterized by presence of Omicron variant. This variant is very contagious, but less often aggressive, especially in pediatric population. Methods We report a case of a 10‐year‐old girl, previously healthy, not yet vaccinated for SARS‐CoV2, presented to our emergency department for left hemiparesis associated with headache and vomiting, without any signs of respiratory tract infection. Results Cerebral CT and MRI showed an ischemic stroke of right sylvian artery. Magnetic resonance angiography performed upon resurgence of new symptoms was in favor of vasculitis on the right internal carotid and right sylvian artery. PCR SARS‐CoV2 was positive for Omicron variant. She fully recovered after few days and was treated with acetylsalicylic acid and intravenous corticosteroids. Conclusion We report this case to raise awareness on the possible complications related to SARS‐CoV2 infection and we highly recommend vaccination in this age group.

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Section: Discussionmentioning

confidence: 99%

Ischemic stroke on SARS‐CoV2 vasculitis in a healthy young girl

Petat

Hassani

Dabaj

et al. 2023

Health Science Reports

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“…31 Such delayed AIS has also been described after weeks or months following other viral infections, such as varicella-zoster. 32 The increased risk of delayed post-COVID AIS could be attributed to the hyperinflammatory and prothrombotic states that may last for a long time (weeks or months) after the resolution of acute viral infection. 33 34 It appears that delayed post-COVID AIS diverges from early AIS concurrent with active SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 99%

Association between SARS-CoV-2 Seropositivity and Severity of Out-of-Hospital Acute Ischemic Stroke Following Asymptomatic/Mild COVID-19 in Children

Abdelkreem,

Mahmoud,

Mohamed

et al. 2023

J Pediatr Infect Dis

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Objective This article investigates the frequency of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity and its association with the severity of new-onset acute ischemic stroke (AIS) among previously healthy children with asymptomatic/mild coronavirus disease 2019 (COVID-19). Methods A case–control study that included children < 18 years with out-of-hospital AIS of undetermined etiology and a control group of healthy children. Exclusion criteria were current respiratory symptoms, previous COVID-19 diagnosis, prior COVID-19 vaccination, active SARS-CoV-2 infection, history of hospital admission in the last 6 months, and having a stroke predisposition. We screened children for SARS-CoV-2 immunoglobulin G antibodies using enzyme-linked immunosorbent assay. The severity of stroke was evaluated using the Pediatric National Institutes of Health Stroke Scale (PedNIHSS). Results The current study included 25 children (15 males and 10 females; median age 24 months) with out-of-hospital AIS and 25 healthy controls (11 males and 14 females; median age 24 months). SARS-CoV-2 seropositivity was detected in 15 (60%) of AIS children and 11 (44%) among controls (p = 0.258). Compared with seronegative AIS children, those seropositive for SARS-CoV-2 had higher PedNIHSS scores (median 19 vs. 8.5; p = 0.001), pediatric intensive care unit admission (93.3% vs. 40%; p = 0.007), need for mechanical ventilation (53.3% vs. 10%; p = 0.040), and D-dimer levels (median 3.5 vs. 1.75 μg/mL; p < 0.001). Conclusion SARS-CoV-2 seropositivity may be associated with more severe AIS affecting previously healthy children during the postacute phase of asymptomatic/mildly symptomatic COVID-19.

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Zerebrale Vaskulitiden bei Kindern und Jugendlichen

Benseler

2022

Pädiatrische Rheumatologie

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An atypical case of post-varicella stroke in a child presenting with hemichorea followed by late-onset inflammatory focal cerebral arteriopathy

Cited by 6 publications

References 42 publications

Ischemic stroke on SARS‐CoV2 vasculitis in a healthy young girl

Ischemic stroke on SARS‐CoV2 vasculitis in a healthy young girl

Association between SARS-CoV-2 Seropositivity and Severity of Out-of-Hospital Acute Ischemic Stroke Following Asymptomatic/Mild COVID-19 in Children

Zerebrale Vaskulitiden bei Kindern und Jugendlichen

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