Sex: F
Vaccine: VARZOS
Symptoms: Cerebral infarction, Cerebral microangiopathy, Cerebrovascular accident, Computerised tomogram head abnormal, Dysarthria
Clinical narrative: Right hemispheric cerebrovascular accident/Nontraumatic cerebrovascular accident/acute stroke with left upper and lower extremity weakness; embolic ischemic infarct involving right middle cerebral artery; Carotid stenosis; left sided hemiparesis/ hemiparesis; facial palsy partial; Sensory loss; tremors; speech slurred/ impaired speech/ slight Slurred in her speech/mild dysarthria; numbness of the left face ,arm and leg; ataxia one limb; focal neurological defect/Cranial nerves Ill through XII grossly intact; This case was reported by a lawyer and described the occurrence of cerebrovascular accident in a female patient who received Herpes zoster (Shingrix) for product used for unknown indication.   On an unknown date, the patient received Shingrix at an unknown dose. On an unknown date, an unknown time after receiving Shingrix, the patient experienced cerebrovascular accident (serious criteria GSK medically significant) and embolic cerebellar infarction. The action taken with Shingrix was unknown. On an unknown date, the outcome of the cerebrovascular accident and embolic cerebellar infarction were unknown.   It was unknown if the reporter considered the cerebrovascular accident and embolic cerebellar infarction to be related to Shingrix.  Additional information: As per legal complaint, the patient had shingrix and the patient experienced cerebrovascular accident embolic ischemic infarct involving right middle cerebral artery  The initial information was received on 29 April 2020 via medical records (case now medically confirmed).As per pharmacy record, on 13 March 2019 the patient had shingrix 50 mcg injection.The patient was admitted during 21 March 2019 to 28 March 2019. The patient was subsequently being admitted to intensive care unit observation. On 21 March 2019, CT ( computed tomography ) scan done for acute right sided stroke .MRI (magnetic resonance imaging) of brain showed foci of acute ischemic change in the right insular cortex extending into the right centrum semiovale. Mild chronic microangiopathy changes seen. The patient impression included acute stroke right side with left-sided weakness (extremity weakness) status post TPA (tissue plasminogen activator) with partial recannulization of middle cerebral artery. On 21 March 2019 patient carotid doppler with imaging showed carotid stenosis determined by SCET(Symptomatic Carotid Endarterectomy Trial) criteria. the CT angiography of the carotid and vertebral artery, showed occlusion of the arterial branch of the M2 segment and right middle cerebral artery. The patient had nontraumatic cerebrovascular accident- embolic ischemic infarct involving right middle cerebral artery. The patient had right hemispheric cerebrovascular accident, status post tissue plasminogen activator. The patient physical examination included Agency stroke scale score was 9, Facial palsy, sensory loss limb, ataxia one limb and nerves were affected or cranial nerves Ill through XII grossly intact. The patient had tremors and focal neurological defect, mild dysarthria. had left facial left arm and left leg weakness, left sided hemiparesis or hemiparesis. The patient reports numbness of the left face, arm and leg, speech slurred or impaired speech or slight slur in her speech. The patient in the emergency room, had shown significantly improved left upper and lower extremity weakness and slurred speech and facial droop.      Lab Comments: On 21 March 2019, CT ( computed tomography ) scan done on presentation showed acute right sided stroke . MRI (Magnetic resonance imaging) of brain showed  foci of acute ischemic change in the right insular cortex extending into the right centrum semiovale.  On 21 March 2019 patient carotid doppler with imaging showed Carotid stenosis determined by SCET  (Symptomatic Carotid Endarterectomy Trial) criteria. Agency stroke scale score was 9. The CT angiography of the carotid and vertebral artery, showed occlusion of the arterial branch of the M2 segment and right middle cerebral artery