Stroke Status Developed After Herpes Viridae Infection: A Report of Two Cases

Abstract

High mortality herpes simplex virus encephalitis (HSVE) presents with fever, headache, changes in personality, focal neurologic findings, and epileptic attacks. It causes common destruction in brain parenchyma with necrotic, inflammatory and hemorrhagic lesions, and neuron losses. Central nervous system vasculitis during HSV infection can develop strokes especially related to both hemorrhagic and ischemic reasons. Ramsay-Hunt syndrome (RHS) is characterized by the re-activation of the latent varicella zoster virus (VZV) in the geniculate ganglion of the facial nerve; it presents with peripheral facial nerve paralysis. Neurogenic pulmonary edema is the situation of respiratory failure occurring hours after the serious neurogenic incident without other reasons causing lung edema, which is developed by increase in sympathetic activity, and progressed by increase in alveolar and interstitial fluid. In the current study, a patient with developed neurologic pulmonary edema with ischemic stroke status as a result of cerebral hematoma and middle cerebral artery (MCA) ischemia following HSVE was followed up and a patient that developed anterior cerebral artery (ACA) and MCA territory infarction after RHS was mentioned.