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Original Article
Brief Report
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Volume 347:1500-1503 November 7, 2002 Number 19
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Two Patients with Unusual Forms of Varicella–Zoster Virus Vasculopathy
Donald H. Gilden, M.D., Howard L. Lipton, M.D., James S. Wolf, M.D., William Akenbrandt, M.D., John E. Smith, B.A., Ravi Mahalingam, Ph.D., and Bagher Forghani, Ph.D.

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Infection of cerebral arteries by varicella–zoster virus (VZV) can produce unifocal or multifocal vasculopathy. Unifocal large-vessel vasculopathy (granulomatous arteritis) usually affects elderly immunocompetent persons, whereas multifocal vasculopathy occurs primarily in persons who are immunocompromised.1 Unifocal large-vessel infarcts may follow zoster in a trigeminal distribution and are presumed to result from transaxonal transport of virus from trigeminal afferent fibers that innervate vessels of the anterior circulation.2 Similarly, smaller infarcts in deep white and gray matter may reflect transport of VZV from trigeminal or cervical afferent fibers to smaller branches of vessels of the posterior circulation.2,3 We encountered two patients with unusual . . . [Full Text of this Article]

Case Reports

Patient 1

Patient 2

Discussion


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From the Departments of Neurology (D.H.G., J.E.S., R.M.) and Microbiology (D.H.G.), University of Colorado Health Sciences Center, Denver; the Division of Neurology (H.L.L.) and the Department of Radiology (W.A.), Evanston Hospital and Northwestern University School of Medicine, Evanston, Ill.; the Johns Hopkins University School of Medicine, Baltimore (J.S.W.); and the Viral and Rickettsial Disease Laboratory, California Department of Health Services, Richmond (B.F.).

Address reprint requests to Dr. Gilden at the Department of Neurology, Mail Stop B-182, University of Colorado Health Sciences Center, 4200 E. 9th Ave., Denver, CO 80262, or at don.gilden@uchsc.edu.


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