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Herpes Zoster

Clinical Drawings DRG pathology   Early     Hemorrhage   Late Nerve

From: Head H, Campbell AW. The pathology of herpes zoster and its bearing on sensory localization. Brain 1900;23:353-529

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Radicular Rash: T2 root

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Radicular Rash: T7 root

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Zoster-related Dorsal Root Ganglion: Early Pathology
"The inflammation and haemorrhage are situated in the dorsal aspect of the ganglion,
i.e., in that portion opposed to the anterior root. . . .
In the centre of these haemorrhagic foci the ganglion cells are absolutely destroyed. . . .
But [elsewhere] in the affected ganglia many cells are usually seen which show no noticeable alteration,
and in no instance of spontaneous zoster have we been able to see those minor chromatolytic changes
that are so commonly present in degenerative diseases of the nervous system"

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Herpes Zoster: Dorsal Root Ganglion
  Hemorrhage &
  Cellular inflammation Affecting & Around Ganglion cells

H&E stain From: R Schmidt

Hemorrhagic Ganglionitis

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Dorsal Root Ganglion: Unaffected Control (Opposite side)

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Degenerating ganglion cells & Satellite cell inclusions

H&E stain From: R Schmidt

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Zoster-related Dorsal Root Ganglion: Late Pathology
Usually the final result is a scar occupying from one-sixth to a half of the ganglion.
Within this area all ganglion cells and nerve-fibres are destroyed,
and no structure remains to show where they once existed.
But in several cases a few healthy ganglion cells, and still more often a few healthy nerve-fibres,
can be seen scattered in the scar tissue

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Zoster-related Nerve: Axon loss, Differential fascicular

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9/18/2023