Varicella Zoster Virus Vasculopathy Leading to a Recurrent Cerebral Infarction: Differential Treatment Responses Between Stenosis and Occlusion

Varicella zoster virus (VZV) infection can cause vasculopathy and stroke; however, the response of VZV-induced vasculopathy to treatment is still not well understood. We herein report the case of a 41-year-old man with a recurrent cerebral infarction following herpes zoster infection. The patient presented with a visual field disturbance and a history of myelodysplastic syndrome and chronic kidney disease. Magnetic resonance imaging revealed multiple vascular stenoses and occlusions. Despite initial antiviral and steroid therapy, his condition worsened and he required additional treatment. Vessel stenosis responded well to treatment, whereas occlusion did not. An early diagnosis and prompt treatment of VZV-induced vasculopathy are crucial for preventing irreversible vascular damage.