Herpes Zoster oftálmico e posterior acidente vascular cerebral: relato de caso

Guerreiro, Carlos A. M.; Guerreiro, Marilisa M.

doi:10.1590/S0004-282X1984000400015

Resumos

Um caso de acidente vascular cerebral (AVC) 14 semanas após a instalação de herpes zoster oftálmico (HZO) é apresentado. A tomografia computadorizada craniana documentou comprometimento em território de artéria cerebral média ipsilateral ao HZO. O diagnóstico de probabilidade é o de arterite por herpes zoster com posterior trombose. Os autores reviram a literatura e enfatizam o longo intervalo entre o HZO e a instalação da hemiplegia. Citam as novas drogas antivirais que tornam esta causa de AVC potencialmente passível de ser prevenida.

A sixty-nine year old man suffered a stroke fourteen weeks after the onset of right herpes zoster ophthalmicus (HZO). Hemispheric infarction was documented by a computed tomography which showed a small hypodense zone in the right internal capsula; after contrast there was enhancement of this hypodense area. Cerebral angiography and cerebral-spinal fluid were not done. Despite of a diagnosis of probability the authors report the case and review the literature. A long latency between the HZO and onset of neurological deficit is stressed. New antiviral agents may prevent the ictus.

Herpes Zoster oftálmico e posterior acidente vascular cerebral: relato de caso

Herpes Zoster ophthalmicus and delayed cerebral infarction

Carlos A. M. Guerreiro^I; Marilisa M. Guerreiro^II

^IProfessor Assistente de Neurologia. Departamento de Neurologia e Neurocirurgia da Faculdade de Ciências Médicas da Universidade Estadual de Campinas

^IIMédico Residente. Departamento de Neurologia e Neurocirurgia da Faculdade de Ciências Médicas da Universidade Estadual de Campinas

RESUMO

Um caso de acidente vascular cerebral (AVC) 14 semanas após a instalação de herpes zoster oftálmico (HZO) é apresentado. A tomografia computadorizada craniana documentou comprometimento em território de artéria cerebral média ipsilateral ao HZO. O diagnóstico de probabilidade é o de arterite por herpes zoster com posterior trombose. Os autores reviram a literatura e enfatizam o longo intervalo entre o HZO e a instalação da hemiplegia. Citam as novas drogas antivirais que tornam esta causa de AVC potencialmente passível de ser prevenida.

SUMMARY

A sixty-nine year old man suffered a stroke fourteen weeks after the onset of right herpes zoster ophthalmicus (HZO). Hemispheric infarction was documented by a computed tomography which showed a small hypodense zone in the right internal capsula; after contrast there was enhancement of this hypodense area. Cerebral angiography and cerebral-spinal fluid were not done. Despite of a diagnosis of probability the authors report the case and review the literature. A long latency between the HZO and onset of neurological deficit is stressed. New antiviral agents may prevent the ictus.

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Trabalho realizado no Departamento de Neurologia e Neurocirurgia da Faculdade de Ciências Médicas da Universidade Estadual de Campinas.

Departamento de Neurologia e Neurocirurgia, Faculdade de Ciências Médicas da UNICAMP - Caixa Postal 1170 - 13100, Campinas, SP - Brasil.

1. ACERS, T.E. - Herpes zoster ophthalmicus with contralateral hemiplegia. Arch. Ophthalmol. 71:371, 1964.
2. APPELBAUM, E.; KREPS, S.I. & SUNSHINE, A. - Herpes zoster encephalitis. Amer. J. Med. 32:25, 1962.
3. BALFOUR, H.H.; BEAN, B.; LASKIN, O.L.; AMBINDER, R.F.; MEYERS, J.D.; WADE, J.C.; ZAIA, J.A.; AEPPU, D.; KIRK, L.E.; SEGRETI, A.C.; KEENEY, R.E. & THE BURROUGHS WELLCOME COLLABORATIVES ACYCLOVIR STUDY GROUP - Acyclovir halts progression of herpes zoster in immunocompromised patients. N. Engl. J. Med. 308:1448, 1983.
4. BEAN, B.; BRAUN, C. & BALFOUR, H.H. - Acyclovir therapy for acute herpes zoster. Lancet 2:118, 1982.
5. COPE, S. & JONES, A.T. - Hemiplegia complicating ophtalmic zoster. Lancet 2:898, 1964.
6. DOLIN, R.; REICHMAN, R.C.; MAZUR, M.H. & WHITLEY, R.J. - Herpes zoster-varicella infections in immunosuppressed patients. Ann. int. Med. 89:375, 1978.
7. EAGLSTEIN, W.H.; KATZ, R & BROWN, J.A. - The effects of early corticosteroid therapy on skin eruption and pain of herpes zoster. J. amer. med. Assoc. 211:1681, 1970.
8. GILBERT, G.J. - Herpes zoster ophthalmicus and delayed contralateral hemiparesis. J. amer. med. Assoc. 229:302, 1974.
9. GOLD, E. - Serologic and virus isolation studies of patients with varicella or herpes-zoster infection. N. Engl. J. Med. 274:181, 1966.
10. GORDON, I.R.S. & TUCKER, J.F. - Lesion of the central neurvous system in herpes zoster. J. Neurol. Neurosurg. Psychiat 8:40, 1945.
11. HOGAN, E.L.; KRIGMAN, M.R. & HILL, C. - Herpes zoster myelitis. Arch. Neurol. (Chicago) 29:309, 1973.
12. HOUSER, O.W.; CAMPBELL, J.K.; BAKER, H.L. & SUNDT, T.S.Jr. - Radiologic evaluation of ischemic cerebrovascular syndromes with emphais on computed tomography. In N.E, Leeds (ed.): The Radiologic Clinics of North America. Symposium on Neuroradiology 20:123. Saunders, New York, 1982.
13. KOLODNY, E.H.; REBEIZ, J.J.; CAVINESS, C.V.S.Jr. & RICHARDSON, E.P.Jr. - Granulomatous angiitis of the central nervous system. Arch. Neurol. (Chicago) 19:510, 1968.
14. KUROIWA, Y. & FURUKAWA, T. - Hemispheric infarction after herpes zoster ophthalmicus: computed tomography and angiography. Neurology (N.Y.) 31:1030, 1981.
15. LINNEMANN, C.C.Jr. & ALVIRA, M.M. - Pathogenesis of varicella-zoster angiitis in the CNS. Arch. Neurol. (Chicago) 37:239, 1980.
16. McCOMAS, C.F. & GUTMANN, L. - Hemipheric infarticon after herpes zoster ophthalmicus. Neurology (N.Y.) 32:914, 1982.
17. Mccormick, w.c.; rodnitzky, r.l.; schochet, s.sJr. & mckee, a.p. - Varicella - zoster encephalomyelitis. Arch. Neurol. (Chicago) 21:559, 1969.
18. MITCHELL, C.D.; BEAN, B.; GENTRY, S.R.; GROTH, K.E.; BOEN, J.R. & BALFOUR, H.H.Jr. - Acyclovir therapy for mucocutaneous herpes simplex infec-ctions in immunocompromised patients. Lancet 1:1389, 1981.
19. NORRIS, F.H.Jr.; LEONARDS, R.; CALANCHINI, P.R. & CALDER, C.D. - Herpes-zoster meningoencephalitis. J. infect. Dis. 122:335, 1970.
20. PETERSLUND, N.A.; SEYER-HANSEN, K.; IPSEN, J.; ESMANN, V.; SCHONHEY-DER, H. & JUHL, H. - Acyclovir in herpes zoster. Lancet 2:827, 1981.
21. PRATESI, R.; FREEMON, F.R. & LOWRY, J.L. - Herpes zoster ophthalmicus with contralateral hemiplegia. Arch. Neurol. (Chicago) 34:640, 1977.
22. ROSE, F.C; BRETT, E.H. & BURSTON, J. - Zoster encephalomyelitis. Arch. Neurol. (Chicago) 11:155, 1964.
23. ROSENBLUM, W.I. & HADFILD, M.G. - Granulomatous angiitis of the nervous system in cases of herpes zoster and lymphosarcoma. Neurology (Minneapolis) 22:348, 1972.
24. SCHIFF, C.I. & BRAIN, W.R. - Acute meningoencephalitis associated with herpes zoster. Lancet 2:70, 1930.
25. TAKO, J. & RADO, J.P. - Zoster meningoencephalitis in a steroid-treated patient. Arch NeuroL (Chicago) 12:610, 1965.
26. VECHT, C.J. & SANDE, J.J.v.d. - Hemisheric infartion after herpes zoster ophthalmicus. Neurology (N.Y.) 32:914, 1982.
27. VICTOR, D.I. & GREEN, R. - Temporal artery biopsy in herpes zoster ophthalmicus with delayed arteritis. Amer. J. Ophthalmol. 82:628, 1976.
28. WALKER, R.J.; GAMMAL, T.E. & ALLEN, M.B. - Cranial arteritis associated with herpes zoster: case report with angiographic findings. Radiology 107:109, 1973.
29. WHITLEY, R.J.; CH'IEN, L.T.; DOLIN, R.; GALASSO, G.J.; ALPORD, C.A.Jr. & THE COLLABORATIVE STUDY GROUP - Adenine arabinosidetherapy of herpes zoster in the immunosuppressed. N. Engl. J. Med. 294:1193, 1976.
30. WHITLEY, R.J.; SOONG, S.J.; DOLIN, R.; BETTS, R.; LINNEMANN, C.Jr.; ALFORD, C.A.Jr. & THE NIAID COLLABORATIVE ANTIVIRAL STUDY GROUP - Early vidarabine therapy to control the complications of herpes zoster in immunosuppressed patients. N. Engl. J. Med. 307:971, 1982.

Datas de Publicação

Publicação nesta coleção
13 Ago 2012
Data do Fascículo
Dez 1984

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ACERS, T.E. - Herpes zoster ophthalmicus with contralateral hemiplegia. Arch. Ophthalmol. 71:371, 1964.

[2] 2. APPELBAUM, E.; KREPS, S.I. & SUNSHINE, A. - Herpes zoster encephalitis. Amer. J. Med. 32:25, 1962.

[3] 3. BALFOUR, H.H.; BEAN, B.; LASKIN, O.L.; AMBINDER, R.F.; MEYERS, J.D.; WADE, J.C.; ZAIA, J.A.; AEPPU, D.; KIRK, L.E.; SEGRETI, A.C.; KEENEY, R.E. & THE BURROUGHS WELLCOME COLLABORATIVES ACYCLOVIR STUDY GROUP - Acyclovir halts progression of herpes zoster in immunocompromised patients. N. Engl. J. Med. 308:1448, 1983.

[4] 4. BEAN, B.; BRAUN, C. & BALFOUR, H.H. - Acyclovir therapy for acute herpes zoster. Lancet 2:118, 1982.

[5] 5. COPE, S. & JONES, A.T. - Hemiplegia complicating ophtalmic zoster. Lancet 2:898, 1964.

[6] 6. DOLIN, R.; REICHMAN, R.C.; MAZUR, M.H. & WHITLEY, R.J. - Herpes zoster-varicella infections in immunosuppressed patients. Ann. int. Med. 89:375, 1978.

[7] 7. EAGLSTEIN, W.H.; KATZ, R & BROWN, J.A. - The effects of early corticosteroid therapy on skin eruption and pain of herpes zoster. J. amer. med. Assoc. 211:1681, 1970.

[8] 8. GILBERT, G.J. - Herpes zoster ophthalmicus and delayed contralateral hemiparesis. J. amer. med. Assoc. 229:302, 1974.

[9] 9. GOLD, E. - Serologic and virus isolation studies of patients with varicella or herpes-zoster infection. N. Engl. J. Med. 274:181, 1966.

[10] 10. GORDON, I.R.S. & TUCKER, J.F. - Lesion of the central neurvous system in herpes zoster. J. Neurol. Neurosurg. Psychiat 8:40, 1945.

[11] 11. HOGAN, E.L.; KRIGMAN, M.R. & HILL, C. - Herpes zoster myelitis. Arch. Neurol. (Chicago) 29:309, 1973.

[12] 12. HOUSER, O.W.; CAMPBELL, J.K.; BAKER, H.L. & SUNDT, T.S.Jr. - Radiologic evaluation of ischemic cerebrovascular syndromes with emphais on computed tomography. In N.E, Leeds (ed.): The Radiologic Clinics of North America. Symposium on Neuroradiology 20:123. Saunders, New York, 1982.

[13] 13. KOLODNY, E.H.; REBEIZ, J.J.; CAVINESS, C.V.S.Jr. & RICHARDSON, E.P.Jr. - Granulomatous angiitis of the central nervous system. Arch. Neurol. (Chicago) 19:510, 1968.

[14] 14. KUROIWA, Y. & FURUKAWA, T. - Hemispheric infarction after herpes zoster ophthalmicus: computed tomography and angiography. Neurology (N.Y.) 31:1030, 1981.

[15] 15. LINNEMANN, C.C.Jr. & ALVIRA, M.M. - Pathogenesis of varicella-zoster angiitis in the CNS. Arch. Neurol. (Chicago) 37:239, 1980.

[16] 16. McCOMAS, C.F. & GUTMANN, L. - Hemipheric infarticon after herpes zoster ophthalmicus. Neurology (N.Y.) 32:914, 1982.

[17] 17. Mccormick, w.c.; rodnitzky, r.l.; schochet, s.sJr. & mckee, a.p. - Varicella - zoster encephalomyelitis. Arch. Neurol. (Chicago) 21:559, 1969.

[18] 18. MITCHELL, C.D.; BEAN, B.; GENTRY, S.R.; GROTH, K.E.; BOEN, J.R. & BALFOUR, H.H.Jr. - Acyclovir therapy for mucocutaneous herpes simplex infec-ctions in immunocompromised patients. Lancet 1:1389, 1981.

[19] 19. NORRIS, F.H.Jr.; LEONARDS, R.; CALANCHINI, P.R. & CALDER, C.D. - Herpes-zoster meningoencephalitis. J. infect. Dis. 122:335, 1970.

[20] 20. PETERSLUND, N.A.; SEYER-HANSEN, K.; IPSEN, J.; ESMANN, V.; SCHONHEY-DER, H. & JUHL, H. - Acyclovir in herpes zoster. Lancet 2:827, 1981.

[21] 21. PRATESI, R.; FREEMON, F.R. & LOWRY, J.L. - Herpes zoster ophthalmicus with contralateral hemiplegia. Arch. Neurol. (Chicago) 34:640, 1977.

[22] 22. ROSE, F.C; BRETT, E.H. & BURSTON, J. - Zoster encephalomyelitis. Arch. Neurol. (Chicago) 11:155, 1964.

[23] 23. ROSENBLUM, W.I. & HADFILD, M.G. - Granulomatous angiitis of the nervous system in cases of herpes zoster and lymphosarcoma. Neurology (Minneapolis) 22:348, 1972.

[24] 24. SCHIFF, C.I. & BRAIN, W.R. - Acute meningoencephalitis associated with herpes zoster. Lancet 2:70, 1930.

[25] 25. TAKO, J. & RADO, J.P. - Zoster meningoencephalitis in a steroid-treated patient. Arch NeuroL (Chicago) 12:610, 1965.

[26] 26. VECHT, C.J. & SANDE, J.J.v.d. - Hemisheric infartion after herpes zoster ophthalmicus. Neurology (N.Y.) 32:914, 1982.

[27] 27. VICTOR, D.I. & GREEN, R. - Temporal artery biopsy in herpes zoster ophthalmicus with delayed arteritis. Amer. J. Ophthalmol. 82:628, 1976.

[28] 28. WALKER, R.J.; GAMMAL, T.E. & ALLEN, M.B. - Cranial arteritis associated with herpes zoster: case report with angiographic findings. Radiology 107:109, 1973.

[29] 29. WHITLEY, R.J.; CH'IEN, L.T.; DOLIN, R.; GALASSO, G.J.; ALPORD, C.A.Jr. & THE COLLABORATIVE STUDY GROUP - Adenine arabinosidetherapy of herpes zoster in the immunosuppressed. N. Engl. J. Med. 294:1193, 1976.

[30] 30. WHITLEY, R.J.; SOONG, S.J.; DOLIN, R.; BETTS, R.; LINNEMANN, C.Jr.; ALFORD, C.A.Jr. & THE NIAID COLLABORATIVE ANTIVIRAL STUDY GROUP - Early vidarabine therapy to control the complications of herpes zoster in immunosuppressed patients. N. Engl. J. Med. 307:971, 1982.