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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Hauer, L; Pikija, S; Schulte, EC; Sztriha, LK; Nardone, R; Sellner, J.
Cerebrovascular manifestations of herpes simplex virus infection of the central nervous system: a systematic review.
J Neuroinflammation. 2019; 16(1): 19
Doi: 10.1186/s12974-019-1409-4
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- Leading authors Med Uni Graz
- Pikija Slaven
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- Abstract:
- BACKGROUND: Intracerebral hemorrhage and ischemic stroke are increasingly recognized complications of central nervous system (CNS) infection by herpes simplex virus (HSV). AIM OF THE STUDY: To analyze clinical, imaging, and laboratory findings and outcomes of cerebrovascular manifestations of HSV infection. METHODS: Systematic literature review from January 2000 to July 2018. RESULTS: We identified 38 patients (median age 45 years, range 1-73) comprising 27 cases of intracerebral hemorrhage, 10 of ischemic stroke, and 1 with cerebral venous sinus thrombosis. Intracerebral hemorrhage was predominantly (89%) a complication of HSV encephalitis located in the temporal lobe. Hematoma was present on the first brain imaging in 32%, and hematoma evacuation was performed in 30% of these cases. Infarction was frequently multifocal, and at times preceded by hemorrhage (20%). Both a stroke-like presentation and presence of HSV encephalitis in a typical location were rare (25% and 10%, respectively). There was evidence of cerebral vasculitis in 63%, which was exclusively located in large-sized vessels. Overall mortality was 21% for hemorrhage and 0% for infarction. HSV-1 was a major cause of hemorrhagic complications, whereas HSV-2 was the most prevalent agent in the ischemic manifestations. CONCLUSION: We found a distinct pathogenesis, cause, and outcome for HSV-related cerebral hemorrhage and infarction. Vessel disruption within a temporal lobe lesion caused by HSV-1 is the presumed mechanism for hemorrhage, which may potentially have a fatal outcome. Brain ischemia is mostly related to multifocal cerebral large vessel vasculitis associated with HSV-2, where the outcome is more favorable.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent - administration & dosage
- Adult - administration & dosage
- Aged - administration & dosage
- Animals - administration & dosage
- Central Nervous System Viral Diseases - complications
- Cerebrovascular Disorders - etiology, virology
- Child - administration & dosage
- Child, Preschool - administration & dosage
- Female - administration & dosage
- Herpes Simplex - complications, pathology
- Humans - administration & dosage
- Infant - administration & dosage
- Male - administration & dosage
- Middle Aged - administration & dosage
- Young Adult - administration & dosage
- Find related publications in this database (Keywords)
- Cerebrovascular complications
- Herpes simplex virus encephalitis
- Ischemic stroke intracerebral hemorrhage
- Vasculopathy
- Vasculitis
- Mortality