Vertebral Artery Stump Syndrome Caused by Varicella-zoster Virus Vasculopathy in the Absence of a Skin Rash.

A 38-year-old man without skin rash was admitted to our hospital for recurrent cerebral infarctions. Cerebral angiography revealed vertebral artery stump syndrome (VASS), and a high varicella-zoster virus (VZV) antibody index suggested VZV vasculopathy. Treatment with aspirin and anticoagulants was initiated, along with intravenous acyclovir and methylprednisolone sodium succinate. No further cerebral infarction was observed. Clinicians should be aware that VZV vasculopathy may underlie ischemic stroke in young adults and VASS even in the absence of a rash. An early diagnosis and appropriate treatment have contributed to favorable clinical outcomes.