VARICELLA-ZOSTER VIRUS-DNA IN CSF AND ARTERIES IN DELAYED CONTRALATERAL HEMIPLEGIA - EVIDENCE FOR VIRAL INVASION OF CEREBRAL-ARTERIES

A 78-year-old woman presented with a right basal ganglia infarct 6 wee ks after a left herpes tester ophthalmicus. MR angiography showed foca l segmental stenosis of the proximal segments of the anterior, middle, and posterior cerebral arteries. Varicella DNA was detected in the CS F by polymerase chain reaction (PCR). Treated with dexamethasone and a cyclovir without improvement, she died 1 month later. There was focal endarteritis in the left anterior, middle, and posterior cerebral arte ries at autopsy. Varicella DNA was detected by PCR of extracts from th ese vessels but not from the arteries on the right side. This study pr ovides further evidence that the vasculopathy after herpes tester opht halmicus results from direct viral invasion of the vessel wall.