水痘-带状疱疹病毒性脑血管炎的临床表现以及影像学、病理学改变

目的 分析水痘-带状疱疹病毒（VZV）引起的脑动脉炎的临床特征、影像学和病理改变。方法 对2例VZV脑动脉炎患者的临床表现、辅助检查、影像学和病理特征进行了总结。结果 患者为急性起病，表现为脑卒中样发作。从病毒感染到脑梗死的发生间隔时间分别为5d和6个月，头颅MRI表现为半卵圆、双侧基底节区的多发性长T1、长T2信号，注射钆喷酸葡胺（Gd-DTPA）后无增强效应。数字减影血管造影术（DSA）检查发现在大脑中动脉、前动脉存在多处狭窄段。病理学检查发现，在脑组织血管周围有炎性细胞浸润，呈血管鞘样，脑内血管存在多处明显的纤维素样坏死。该病预后良好。结论 VZV引起的脑动脉炎存在病毒前驱感染病史，具有较为特征的临床和影像学表现。

Clinical Features, Neuroimage and Pathologic Changes in Varicella-Zoster Virus-Induced Vasculitis Presenting with Cerebral Infarction

Objective To analyze the clinical features,neuroimage and pathologic changes in varicella-zoster virus-induced vasculitis presenting with cerebral infarction.Methods The clinical data including clinical manifestation,laboratory examination,neuroimage and pathologic changes of the two patients with varicella-zoster virus-induced vasculitis presenting with cerebral infarction were collected and analyzed.Results The patients presented acute ischemic-stroke episode attacks.The latent period between the viral infection and neurological complaints was 5 days and 6 months respectively,MRI image showed abnormal signals in the territory of the bilateral anterior and middle cerebral artery,indicated the presence of acute multi-focal infarction,and digital subtraction angiography(DSA)showed multiple scattered segments of irregularity and narrowing involving the small and medium-sized vessels.Neuropathologic study demonstrated fibrinoid necrosis and infiltration of inflammation cells around vessel wall.Conclusions Varicella-zoster virus-induced cerebral vasculitis has a prodrome of viral infection,and possesses characteristic clinical features.