Neurology: Case of the Month

Test Yourself — Patient 27

Varicella Vasculitis

1. All of the following are causes of "stroke in the young", EXCEPT:
   • [ A ] Atherosclerosis
   • [ B ] Cardiac valvular abnormalities
   • [ C ] Moya-Moya disease
   • [ D ] CNS vasculitis
   • [ E ] Maple syrup urine disease
2. Which of the following may cause paroxysmal events during childhood:
   • [ A ] Migraine
   • [ B ] Seizures
   • [ C ] Mitochondrial defects
   • [ D ] CNS vasculitis
   • [ E ] A and B
   • [ F ] All of the above
   • [ G ] None of the above
3. All of the following statements regarding post-varicella vasculitis are TRUE, EXCEPT:
   • [ A ] Clinical features usually include hemiplegia and speech difficulites.
   • [ B ] Treatment involves aggressive anticoagulation followed by prolonged plasmaphoresis.
   • [ C ] Recurrences may occur up to several months after the initial manifestations.
   • [ D ] The MCA territory is most commonly involved.
   • [ E ] The natural course of the disease is complete, or nearly complete, remission of symptoms.
4. Angiographic features suggestive of an acute vasculitis include all of the following, EXCEPT:
   • [ A ] Focal dilitation of an arterial segment
   • [ B ] Beading of the arteries
   • [ C ] Abrupt truncation of arteries
   • [ D ] Profuse proliferation of small pial vessels
5. Which of the following represents a correct match between cause of "stroke in the young" and treatment for that condition?
   • [ A ] Atrial fibrillation – careful observation
   • [ B ] Protein C deficiency – immediate institution of warfarin anticoagulation to prevent further thrombosis
   • [ C ] Homocysteinuria – vitamin E replacement
   • [ D ] Post-varicella vasculitis – aggressive immunosuppression
   • [ E ] Anticardiolipin antibody syndrome – anticoagulation

 

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