Markers of endothelial activation and purinergic signaling have been identified in the context of ZIKV neuropathogenesis, although the underlying mechanisms remain poorly understood.<h4>Methods</h4>Brain tissue samples from fatal cases of ZIKV-induced microcephaly were analyzed using immunohistochemistry to detect endothelial activation markers (E-selectin, P-selectin, ICAM-1, and VCAM-1) and purinergic receptors (P2X4, P2X7, and P2Y2). Here, ICAM1 is linked to microcephaly.