acyclovir and Carotid-Artery-Diseases

Acute isolated sphenoid sinusitis is a relatively uncommon entity. Because its symptoms and clinical findings are nonspecific, it can be easily misdiagnosed. Left unrecognized and untreated, it can lead to several well-known and severe complications, including meningitis, cerebral abscess, cavernous sinus thrombosis, and epidural or subdural empyema. We report the case of a 28-year-old woman with acute sphenoid sinusitis complicated by ischemic stroke in the left caudate nucleus, lentiform nucleus, and posterior part of the internal capsule. The stroke was diagnosed on magnetic resonance imaging. Also, magnetic resonance angiography showed a narrowing of the internal carotid artery and a narrowing of the first part of the left anterior and middle cerebral arteries (A1 and M1 segments). The patient was treated with medical therapy, including antibiotics, and surgical drainage of the sphenoid sinus via an endoscopic approach. Her outcome was good, and she experienced minimal neurologic sequelae. We discuss the possible explanations for this rare complication.

Topics: Acute Disease; Acyclovir; Adult; Anti-Bacterial Agents; Anticoagulants; Antiviral Agents; Carotid Artery Diseases; Cefotaxime; Dalteparin; Dexamethasone; Female; Glucocorticoids; Humans; Magnetic Resonance Angiography; Sphenoid Sinusitis; Stroke; Tomography, X-Ray Computed; Vancomycin

Intracranial aneurysms in the pediatric population are relatively rare entities. Immunocompromised patients (often from HIV/AIDS or pharmacological immunosuppression) represent a significant fraction of children with cerebral aneurysms. One proposed mechanism of aneurysm formation in these patients is from direct infection of the affected arteries. In this study, the authors report on a case of a 14-year-old girl with common variable immunodeficiency with T-cell dysfunction and a CSF polymerase chain reaction test positive for varicella-zoster virus who underwent evaluation for carotid and basilar artery fusiform aneurysms.

Topics: Acyclovir; Adolescent; Aneurysm; Angiography, Digital Subtraction; Antiviral Agents; Aspirin; Basilar Artery; Carotid Artery Diseases; Carotid Artery, Internal; Cerebral Angiography; Common Variable Immunodeficiency; Female; Herpes Zoster; Humans; Image Processing, Computer-Assisted; Intracranial Aneurysm; Magnetic Resonance Angiography; Platelet Aggregation Inhibitors; T-Lymphocytes; Tomography, X-Ray Computed; Valacyclovir; Valine; Vasculitis; Vertebral Artery

Topics: Acyclovir; Aged; Amphotericin B; Aneurysm; Aneurysm, Infected; Anti-Infective Agents; Brain Edema; Carotid Artery Diseases; Carotid Artery, Internal; Ceftriaxone; Dexamethasone; Embolization, Therapeutic; Equipment Contamination; Female; Humans; Imaging, Three-Dimensional; Infarction, Middle Cerebral Artery; Magnetic Resonance Imaging; Meningoencephalitis; Prostheses and Implants; Prosthesis-Related Infections; Tomography, X-Ray Computed