Varicella zoster vasculopathy presenting as lateral medullary syndrome

Excerpt

Stroke is the second leading cause of death above the age of 60 years and the fifth leading cause in people aged 15 to 59 years old (WHO 2012). While established risk factors such as hypertension, diabetes, obesity, and hypercholesterolemia have been identified and are targets for stroke prevention, viral infections have also emerged as risk factors for stroke (Nagel et al. 2010). In the post-human immunodeficiency virus (HIV) era, not only acquired immunodeficiency syndrome (AIDS) but other opportunistic infections like cytomegalovirus (CMV) and varicella zoster virus (VZV) have been implicated and also proven as causative factors of stroke. This needs to be looked into diligently in patients who present with atypical history of stroke or an infective prodrome preceding stroke. Infections being causative of vasculopathy have been shown in a recent case series (Gilden et al. 2009). We report an interesting case presenting with posterior circulation stroke following zoster rash, which improved with definitive treatment, and discuss the current knowledge on the subject. …