Post-varicella basal ganglia infarct

Additional clinical history: Patient has a history of varicella infection.


Findings

Focal area of hyper intense signal R basal ganglia with increased signal on diffusion imaging and decreased signal on ADC map. Post contrast images showed no enhancement.

Differential diagnosis
- Basal ganglia infarct
- Basal ganglia neoplasm (germinoma)
- Infection (parainfluenza)


Diagnosis: Post-varicella basal ganglia infarct


Key points

Generally presents with unilateral hemiparesis.
Neurologic deficits improve over time with good prognosis.
Usually occurs between 1-4 months after varicella infection.
Etiology is spasm of lenticulostriate arteries.
Treatment: No consensus but steroids or antiplatelet agents are being used.