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Table 4 Characteristics of patients with ischemic manifestations of HSV CNS infection

From: Cerebrovascular manifestations of herpes simplex virus infection of the central nervous system: a systematic review

No. (year), reference Age, sex HSV type, diagnostic test, CSF cell count Clinical presentation, special features Presence of loco-typico HSV-encephalitis Time from symptom onset to admission, ischemia on first imaging Presence of vasculitis (affected vessel), affected brain region Steroids, dosage (duration) Outcome (mRS)
1 (2004), Alexandri NM [43] 31, m HSV-1, PCR, 46 cells/μl Encephalitis (fever, hallucinations, headache) Yes Not reported, no (CT) No, multifocal (anterior and posterior) Hemianopsia (2)
2 (2009), Sas AM [44] 3, f HSV-1, PCR, 38 cells/μl Encephalitis (fever, impaired vision, nausea, vomiting) No Day 5, yes (CT and MRI) No, multifocal (posterior) Blindness (3)
3 (2012), Zepper P [45] 72, m HSV-2, PCR, 588 cells/μl Stroke-like (aphasia, hemiparesis) No Unclear, no (hemorrhage on CT) Yes (various vessels), multifocal (anterior and posterior) Moderate cognitive deficits and hemiparesis (3–4)
4 (2013), Guerrero WR [46] 36, f HSV*, PCR, 13 cells/μl Encephalitis (headache, diplopia with skew deviation), 2 months postpartum No Day 2, yes (MRI) Yes (basilar artery), single lesion (posterior) MP 3 days, P 7 days, dosages not reported Internuclear ophthalmoplegia (3)
5 (2014), Terlizzi V [47] 10, f HSV-1, IgG antibodies appeared in CSF, 20 cells/μl Stroke-like (headache and hemiparesis) No Day 1, no (CT) Yes (distal ICA and MCA), multifocal (anterior) Complete recovery (0)
6 (2014), Snider SB [52] 57, f HSV-2, PCR, 1260 cells/μl Meningitis (headache, nausea, vomiting, photophobia) No Unclear, no (hemorrhage on CT) Yes (various vessels), multifocal (anterior and posterior) Yes, dosage not reported, 21 days Minimal deficits (1–2), resolution of stenoses
7 (2016), Zis P [48] 45, m HSV-2, PCR, 64 cells/μl Encephalitis (fever, confusion) No Day 1, no (CT) Not studied, multifocal (anterior) Mild cognitive deficits (2)
8 (2016), Joshi P [49] 48, f HSV-2, PCR, 16 cells/μl Meningitis (fever, headache, neck stiffness), later encephalitis No Day 120, yes (MRI) Yes (various vessels), multifocal (anterior and posterior) MP and P dosage/duration not reported Relapsing course, outcome not reported
9 (2017), Tsuboguchi S [50] 73, f HSV*, PCR (6000 copies/ml), 8 cells/μl Stroke-like (hemiparesis) No Day 1, yes (MRI) Not studied, multifocal (anterior and posterior) Yes, MP 500 mg, 3 days Modified Rankin scale 5
10 (2017), Zhang F [51] 68, f HSV-2, PCR, 649 cells/μl Encephalitis (headache, numbness, hallucinations), systemic lupus, and immunosuppression No Day 21, yes (MRI) No, multifocal (anterior) Complete recovery (0)
  1. *PCR methodology did not distinguish between HSV-1 and HSV-2. m male, f female, + yes, no, n.a. not available, CSF cerebrospinal fluid, MCA middle cerebral artery, MP methylprednisone