J Clin Neurol.  2011 Mar;7(1):40-42. 10.3988/jcn.2011.7.1.40.

Multiple Cerebral Arterial Stenosis Associated with Hepatitis B Virus Infection

• Kim JT
• Park MS
• Nam TS
• Choi SM
• Lee SH
• Kim BC
• Kim MK
• Cho KH

• KMID: 1452572
• DOI: http://doi.org/10.3988/jcn.2011.7.1.40

Abstract

BACKGROUND
There are conflicting findings regarding the association between hepatitis B (HB) virus (HBV) infection and atherosclerosis.
CASE REPORT
A 34-year-old man was admitted for transient dysarthria and facial palsy. Ten years previously he had been diagnosed with HBV infection and treated with lamivudine (100 mg/day). Reactivation of HBV was detected 6 months before this recent admission. Serologic tests revealed that he was positive for HB early antigen, HB surface antigen, and anti-HB core. Brain magnetic resonance images were normal, but magnetic resonance angiograms revealed severe stenosis of the right middle cerebral artery, both external carotid arteries, and the basilar artery.
CONCLUSIONS
This case report reveals that a young patient with reactivated HBV developed multiple arterial stenoses even though he had no risk factors for this disease.

Keyword

hepatitis B virus; atherosclerosis; reactivated HBV infection; multiple cerebral arterial stenoses

MeSH Terms

Adult
Antigens, Surface
Atherosclerosis
Brain
Carotid Artery, External
Constriction, Pathologic
Dysarthria
Facial Paralysis
Hepatitis
Hepatitis B
Hepatitis B virus
Humans
Lamivudine
Magnetic Resonance Spectroscopy
Middle Cerebral Artery
Risk Factors
Serologic Tests
Viruses
Antigens, Surface
Lamivudine

Figure

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  Fig. 1 Conventional cerebral angiogram. A: Right carotid angiogram showing severe focal stenosis in the midportion of the middle cerebral artery (arrows) that is eccentric and irregular. B: Carotid angiogram showing stenosis of both external carotid arteries (dotted arrows). C: Right vertebral arteriogram showing severe stenosis of the proximal basilar artery and left distal vertebral artery (arrows).

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