title: Varicella-Zoster Virus Vasculopathy: A Case Report Demonstrating Vasculitis using Black-Blood MRI.
abstract: Infections are rare but important causes of stroke. Among these, varicella zoster virus has been known to cause ischemic stroke. During an attack of herpes zoster ophthalmicus, it has been hypothesized that the virus replicates in the trigeminal ganglion and travels via the trigeminal nerve centrally to cause cerebral vasculopathy. Here we present a case of a 69 year-old Caucasian immunocompromised woman who suffered recurrent ischemic infarcts within the same vascular distribution following an episode of zoster ophthalmicus three months prior. An imaging technique termed black-blood magnetic resonance imaging was utilized to aid in the diagnosis of cerebral vasculitis. The case is used to provide a literature review of the pathogenesis, diagnosis, and treatment of cerebral varicella zoster vasculopathy. In situations where an isolated unilateral cerebral vasculopathy is identified, neurologists are urged to consider varicella zoster as a treatable etiologic agent, as untreated vasculopathy can lead to further strokes.
authors.affiliation: Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Jay
authors.initials: J
authors.lastname: Shah
authors.affiliation: Department of Infectious Diseases, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Husain
authors.initials: H
authors.lastname: Poonawala
authors.affiliation: Department of Infectious Diseases, University of Maryland School of Medicine, Baltimore, Maryland ; Medical Service, VAMHCS, Baltimore, Maryland.
authors.forename: Susan K
authors.initials: SK
authors.lastname: Keay
authors.affiliation: Department of Radiology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Yafell
authors.initials: Y
authors.lastname: Serulle
authors.affiliation: Department of Radiology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Andrew
authors.initials: A
authors.lastname: Steven
authors.affiliation: Department of Radiology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Dheeraj
authors.initials: D
authors.lastname: Gandhi
authors.affiliation: Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland ; Veterans Affairs Maryland Health Care System (VAMHCS) Geriatrics Research, Education, and Clinical Center, Baltimore, Maryland.
authors.forename: John W
authors.initials: JW
authors.lastname: Cole
keywords: Black-blood MRI; Stroke; Varicella zoster virus vasculopathy; Vasculitis; Zoster ophthalmicus