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Case reports have suggested that herpes zoster acutely raises risk for cerebrovascular accident (CVA); postulated mechanisms include generalized endothelial dysfunction associated with acute infections and specific destructive effects of zoster on vascular walls. Researchers probed a clinical database of >5 million patients to characterize the association between zoster and CVA.
Among adults with new diagnoses of zoster, overall risk for both ischemic and hemorrhagic stroke rose significantly in the first month after diagnosis, slowly diminished during the following 6 months, and vanished by 1 year. The effect was mitigated by antiviral treatment: Among treated patients, risk for stroke in the first month was not significantly different from…