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Cerebrovascular events after herpes zoster infection: a risk that should be not underestimated

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Abstract

The occurrence of a cerebrovascular event after a herpes zoster (HZ) infection represents a nightmare in clinical practice, especially in those patients with concomitant cardiovascular comorbidities/risk factors and disease related per se to a higher risk of zoster infection. Moreover, the absence of a consensus opinion regarding a specific and adequate prevention of cerebrovascular events in these patients further complicates the treatment. Accumulating evidences demonstrated that HZ and HZ ophtalmicus (HZO) increase the risk of cerebrovascular events in the short-and long-term periods. Moreover, patient’s ages < 40 years old, despite having fewer traditional cardiovascular comorbidities, demonstrated a higher risk of cerebrovascular events after both HZ and HZO infection. Further prospective studies are needed to analyse the role of antiviral treatments and vaccination in these subjects to clarify if they could be able to reduce the risk of stroke after a zoster infection. In the meanwhile, physicians must be aware of a higher risk of cerebrovascular events, especially in younger patients, with few cardiovascular risk factors, after an HZ infection.

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Authors and Affiliations

  1. Section of Internal and Cardiopulmonary Medicine, University of Ferrara, Ferrara, Italy

    Marco Zuin

  2. Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Via WA Mozart, 9, 37040 Legnago, Verona, Italy

    Gianluca Rigatelli

  3. Division of Neurology, Stroke Center, SacroCuore-Don Calabria Hospital, Negrar, Italy

    Alessandro Adami

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  1. Marco Zuin
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  2. Gianluca Rigatelli
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  3. Alessandro Adami
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Correspondence to Gianluca Rigatelli.

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Zuin, M., Rigatelli, G. & Adami, A. Cerebrovascular events after herpes zoster infection: a risk that should be not underestimated. J. Neurovirol. 25, 439–447 (2019). https://doi.org/10.1007/s13365-019-00748-9

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