Post Varicella Arterial Ischaemic Stroke in Denmark 2010-2016

Publication date: Available online 1 December 2017
Source:Pediatric Neurology
Author(s): Ida Glode Helmuth, Kåre Mølbak, Peter Vilhelm Uldall, Anja Poulsen
Background: Varicella, most often a benign disease of childhood, is associated with an increased risk of arterial ischaemic stroke (AIS) in children. The aim of the present study was to estimate the incidence of post varicella AIS in the Danish child population and describe clinical characteristics of children admitted with post varicella AIS. Methods: In the Danish National Patient Register, we identified inpatients 28 days-16 years of age with a discharge diagnosis of stroke and/or cerebrovascular disease from 2010-2016. Medical files were reviewed and children with AIS and varicella infection <12 months before onset of symptoms included. Results: We identified 15 children with AIS and varicella <12 months before. In nine children, the diagnosis was confirmed by detection of VZV DNA or VZV IgG in cerebrospinal fluid. All children were previously healthy, the mean age was 4 years and 67% were male. The median time from varicella rash to AIS was 4.6 months. The most common location of AIS was the basal ganglia and affected vessels were most often in the anterior circulation. Fifty-three percent experienced neurologic sequelae of varying degree. Conclusions: In Denmark, where varicella vaccination is not part of the childhood vaccination programme the estimated risk of post varicella AIS was 1 case (including possible cases) out of 26, 000 children with varicella.



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