Document Detail


Post-varicella arteriopathy of childhood: natural history of vascular stenosis.
MedLine Citation:
PMID:  15728288     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the course of vascular changes in childhood post-varicella arteriopathy (PVA) and its relationship to recurrent arterial ischemic stroke or TIA (AIS/TIA). METHODS: Subjects were children with AIS/TIA occurring <1 year after varicella, ischemic localization consistent with unilateral disease affecting the supraclinoid internal carotid artery or proximal anterior or middle cerebral arteries, and no identified AIS/TIA etiology other than PVA. Charts, brain MRI, and sequential cerebral vessel imaging (selective cerebral angiography or MR angiography [SCA/MRA]) were retrospectively reviewed. RESULTS: Twenty-three children had varicella at age 1.0 to 10.4 years and had single or multiple AIS/TIAs 4 to 47 weeks later. Initial SCA/MRA was performed within 1 month of presentation, and each child had one to five repeat SCA/MRAs during a 4- to 87-month period. There was vascular stenosis in 19 children, maximal on initial studies in 15 of these. Subsequent stenosis regression occurred in 17 children. In 11 of these, one or two additional SCA/MRAs showed further regression as long as 48 months after presentation; there was no restenosis. Eight of 23 children had recurrent AIS/TIA with antithrombotic therapy within 33 weeks of presentation, including 1 of 17 children with documented stenosis regression. CONCLUSION: Vascular stenosis of childhood post-varicella arteriopathy takes a monophasic course, generally with subsequent stenosis regression and only occasional stenosis progression after arterial ischemic stroke/TIA. Arterial ischemic stroke/TIA rarely recurs with antithrombotic prophylaxis after stenosis regression occurs.
Authors:
Sylvain Lanthier; Derek Armstrong; Trish Domi; Gabrielle deVeber
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Neurology     Volume:  64     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-02-24     Completed Date:  2005-10-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  660-3     Citation Subset:  AIM; IM    
Affiliation:
Cerebrovascular Disease Centre, Centre hospitalier de l'Université de Montréal and Montreal Heart Institute, Montreal, Quebec.
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / administration & dosage,  therapeutic use
Aspirin / administration & dosage,  therapeutic use
Brain Ischemia / drug therapy,  epidemiology,  etiology*,  prevention & control,  radiography
Carotid Artery, Internal / pathology,  radiography
Carotid Stenosis / epidemiology,  etiology*,  radiography
Cerebral Angiography
Chickenpox / complications*
Child
Child, Preschool
Cohort Studies
Disease Progression
Drug Therapy, Combination
Female
Fibrinolytic Agents / administration & dosage,  therapeutic use
Follow-Up Studies
Heparin / administration & dosage,  therapeutic use
Heparin, Low-Molecular-Weight / administration & dosage,  therapeutic use
Humans
Infant
Ischemic Attack, Transient / drug therapy,  epidemiology,  etiology*,  pathology,  radiography
Magnetic Resonance Angiography
Male
Middle Cerebral Artery / pathology,  radiography
Recurrence
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Fibrinolytic Agents; 0/Heparin, Low-Molecular-Weight; 50-78-2/Aspirin; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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