Varicella-Zoster Virus Vasculopathy: A Case Report Demonstrating Vasculitis using Black-Blood MRI

Area of Science:

• Neurology
• Infectious Diseases
• Vascular Medicine

Background:

• Infections are infrequent but significant causes of stroke.
• Varicella zoster virus (VZV) is a known cause of ischemic stroke.
• VZV may cause cerebral vasculopathy by affecting the trigeminal nerve.

Purpose of the Study:

• To present a case of recurrent ischemic infarcts secondary to herpes zoster ophthalmicus.
• To review the pathogenesis, diagnosis, and treatment of cerebral VZV vasculopathy.
• To emphasize VZV as a treatable cause of unilateral cerebral vasculopathy.

Main Methods:

• Case presentation of a 69-year-old immunocompromised woman with recurrent ischemic infarcts.
• Literature review on cerebral varicella zoster vasculopathy.
• Utilized black-blood magnetic resonance imaging for diagnosis.

Main Results:

• The patient experienced recurrent ischemic infarcts in the same vascular territory after zoster ophthalmicus.
• Black-blood MRI aided in diagnosing cerebral vasculitis.
• Literature review provided insights into VZV vasculopathy.

Conclusions:

• Cerebral varicella zoster vasculopathy is a rare but important cause of stroke.
• Neurologists should consider VZV in cases of isolated unilateral cerebral vasculopathy.
• Prompt treatment of VZV vasculopathy can prevent further strokes.