Varicella‐Zoster Virus and Cerebral Aneurysm: Case Report and Review of the Literature

Abstract

We report a case of varicella-zoster vasculopathy that occurred in a 42-year-old renal transplant recipient with concurrent vertebral artery aneurysm and dissection. The patient was successfully treated with embolization and acyclovir therapy. Here, we review the English literature regarding the association of varicella-zoster virus infection with cerebral aneurysm.

The complexity of HIV vasculopathy

“…3,4 When presence of VZV was investigated it mainly involved measuring active viral replication via CSF PCR, which, as discussed below, may not always be relevant. Nevertheless, there are several cases where VZV antigen was not histologically detected and where HIV was identified in the vessel wall by immune-histochemistry (anti-gp41) or PCR.…”

“…Fusiform aneurysmal dilatation is less common. 3 Recently Nagel et al 6 described 3 histologically confirmed cases of stroke due to varicella vasculopathy. These were both early (4 weeks after VZV infection) and late VZV (48 weeks after infection) vascular presentations and showed surprisingly widespread involvement of cerebral vasculature.…”

Relationship of Coping Responses and Anxiety Symptoms in Hispanic Youth

“…Inflammation and occlusions of the extra-cranial vessels like common carotid arteries, central retinal artery occlusion, internal carotid artery occlusion, thrombosis, and vasospasm [17,18].…”

Update on Varicella Zoster Virus Vasculopathy

“…Three further cases of aneurysm caused by VZV infection in patients with AIDS were recently reported [24]. In another case of VZV vasculopathy, a 42-year-old renal transplant recipient with concurrent vertebral-artery aneurysm and dissection was successfully treated with embolisation and acyclovir therapy [25]. Most remarkable is the recent report of a patient with zoster in multiple dermatomes, severe headache and normal MRA and 4-vessel digital subtraction angiogram who developed 9 anterior circulation aneurysms 2 months later; antiviral treatment resulted in clinical improvement, size reduction of most aneurysms and complete resolution of the two largest aneurysms [26].…”