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Curr Neurol Neurosci Rep. 2016 Feb;16(2):12. doi: 10.1007/s11910-015-0614-5.

Developments in Varicella Zoster Virus Vasculopathy.

Author information

1
Department of Neurology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Box B182, Aurora, CO, 80045, USA. maria.nagel@ucdenver.edu.
2
Department of Neurology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Box B182, Aurora, CO, 80045, USA. don.gilden@ucdenver.edu.
3
Department of Immunology & Microbiology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Box B182, Aurora, CO, 80045, USA. don.gilden@ucdenver.edu.

Abstract

Varicella zoster virus (VZV) is a highly neurotropic human herpesvirus. Primary infection usually causes varicella (chicken pox), after which virus becomes latent in ganglionic neurons along the entire neuraxis. VZV reactivation results in zoster (shingles) which is frequently complicated by chronic pain (postherpetic neuralgia). VZV reactivation also causes meningoencephalitis, myelitis, ocular disorders, and vasculopathy, all of which can occur in the absence of rash. This review focuses on the association of VZV and stroke, and on the widening spectrum of disorders produced by VZV vasculopathy in immunocompetent and immunocompromised individuals, including recipients of varicella vaccine. Aside from ischemic stroke, VZV infection of cerebral arteries may lead to development of intracerebral aneurysms, with or without hemorrhage. Moreover, recent clinical-virological case reports and retrospective pathological-virological analyses of temporal arteries positive or negative for giant cell arteritis (GCA) indicate that extracranial VZV vasculopathy triggers the immunopathology of GCA. While many patients with GCA improve after corticosteroid treatment, prolonged corticosteroid use may potentiate VZV infection, leading to fatal vasculopathy in the brain and other organs.

KEYWORDS:

Aneurysm; Giant cell arteritis; Stroke; Varicella zoster virus vasculopathy; Zoster

PMID:
26750127
PMCID:
PMC5489063
DOI:
10.1007/s11910-015-0614-5
[Indexed for MEDLINE]
Free PMC Article

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