Open AccessUnilateral herpes zoster ophthalmicus with bilateral cerebral infarcts in human immunodeficiency virus seropositive patient
Author(s) -
Girish Baburao Kulkarni,
Veerendrakumar Mustare,
Masoom Abbas Mirza
Publication year - 2014
Publication title -
journal of neurosciences in rural practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.331
H-Index - 22
eISSN - 0976-3147
pISSN - 0976-3155
DOI - 10.4103/0976-3147.133584
Subject(s) - herpes zoster ophthalmicus , medicine , stroke (engine) , ganglion , rash , complication , varicella zoster virus , trigeminal ganglion , surgery , virus , immunology , anatomy , mechanical engineering , psychology , sensory system , engineering , cognitive psychology
Ischemic stroke is a recognized complication of herpes zoster ophthalmicus. Arterial involvement is usually seen on the side of the rash. It is thought to be due to vessel inflammation by the virus, which travels from the trigeminal ganglion. Few case reports of bilateral and distant site of zoster lesions with stroke in the brain have been described. These reports suggest possibility of contiguous vascular, cerebrospinal fluid (CSF) or hematogenous spread of the virus from the ganglion to the cerebral blood vessels. Therapeutically acyclovir, anticoagulation, and steroids have been used in the treatment of the zoster associated with stroke. We describe a case of immunocompromised patient with ipsilateral zoster ophthalmicus with bilateral anterior circulation strokes, who was treated with above measures and made successful recovery. This report also raises/supports possible CSF/vascular/hematogenous spread of the virus from the ganglion to involve cerebral blood vessels leading to the stroke.