Varicella-Zoster Virus (VZV) Vasculitis

This is a case of varicella zoster vasculitis involving an immunocompromised 52-year-old female. The small vessel component of the vasculitis results in multiple areas of T2/FLAIR hyperintense signal involving both the cortical grey matter and subcortical/deep white matter of the supratentorial compartment, as demonstrated in the first two images. Furthermore, small regions of cytotoxic edema may develop, as in this case, predominately involving the deep white matter of the supratentorial compartment, images 3 and 4. A few of the regions of cytotoxic edema demonstrated hemorrhagic conversion on the susceptibility weighted images. The final two 3D-time-of-flight MRA images demonstrates that varicella vasculitis can result in multiple areas of segmental narrowing of the proximal segments of the cerebral arteries.