Recurrent stroke in varicella zoster associated vasculopathy

Varicella zoster virus (VZV) is well known for its neurotropism, primary infection and reactivation after variable latency periods. After from spinal or cranial nerve ganglia, viruses can affect the central nervous system vasculature via transaxonal migration followed by transmural spread adventitial layer to intima. Stroke occur following VZV (varicella) (zoster). These infectious vasculitides lead unifocal multifocal ischemic hemorrhagic stroke either dermatomal zoster. Usual difference between immunocompetent versus immunocompromised individuals involvement of large vessel vasculopathy in former while small later. This some cases may be progressive leading recurrent even antiviral treatment. Diagnosis becomes challenging needs a high degree suspicion immunocompetent, younger individuals, absence rash when there are comorbidities. We report case elderly women, who developed infarcts ventricular subarachnoid haemorrhage thoracic varicella was confirmed presence anti-VZV IgG antibodies cerebrospinal fluid. In view diverse clinic-radiological spectrum vasculopathy, early recognition this clinical entity warranted improved outcome.