Acute ischemic stroke occurs in 3.3/100,000 children per year. Up to 30% of these are caused by varicella. This can be diagnosed if the patient has had varicella infection within the past 12 months, has a unilateral stenosis of a great vessel, and has a positive PCR or IgG from the CSF.
Treatment includes anticoagulation, acyclovir for at least 7 days and steroids for 3-5 days.
Outcome is normally good and spontaneous improvement can be seen.
Inflammation of other arteries, including other areas of the brain, can also be seen. Treatment options for this can include high dose glucocorticoids and possibly immunosuppresive agents.
References
Simma et al. Therapy in pediatric stroke. Eur J Pediatr. Published online 06 November 2012.
