A case of intracranial saccular aneurysm after primary varicella zoster virus infection

We report a case of intracranial saccular aneurysm that developed 3. years after post-varicella ischemic stroke. A 6-year-old girl without apparent immunologic defects presented with right hemiparesis and expressive aphasia 1. month after chickenpox. Her magnetic resonance imaging scans revealed left basal ganglia infarction because of left lenticulostriate artery occlusion. Although her neurologic symptoms improved gradually, segmental irregular narrowing remained in the A1 and M1 segments of the left anterior and middle cerebral arteries, respectively. Three years later, the follow-up magnetic resonance angiography indicated saccular aneurysm in the anterior communicating artery and the anti-VZV IgG antibody index in the cerebrospinal fluid was elevated. Subclinical reactivation of VZV and the segmental vascular narrowing might cause intracranial aneurysm, even in immunocompetent children.