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Case of the Month: May 2025

Case history

  • 50-year-old patient presented with visual disturbance and left-sided weakness.
  • CSF PCR was positive for VZV.

vzv_vasculitis_1

Click to reveal diagnosis

VZV Vasculitis

  • MRI showed multiple left MCA territory infarcts.
  • There was thick eccentric enhancement on the right MCA but no stenosis initially.

  • After 5 months and following steroid therapy, the enhancement associated with the vasculopathy regressed but a severe long-segment stenosis developed, which only slightly improved on further follow-up MRA.

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