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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