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Cerebral Venous Sinus Thrombosis Complicating Herpes Zoster Ophthalmicus Ophthalmoplegia

Meithem Ali1, Nonyelum Obiechina2, Kay Teck Ling3

  • 1Acute Care Common Stem, NHS England Kent, Surrey and Sussex, Kent, GBR.

Cureus
|April 22, 2024
PubMed

Insights

Cerebral venous thrombosis (CVT) is a rare stroke cause, more common in young females. This case highlights a rare association between herpes zoster virus infection and CVT in an older patient.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Vascular Medicine

Background:

  • Cerebral venous sinus thrombosis (CVST) is an uncommon cause of stroke, predominantly affecting individuals under 50.
  • CVST is more prevalent in females and linked to factors like pregnancy, oral contraceptives, thrombophilia, and malignancy.
  • Recent associations include COVID-19 and its vaccine, with rare links to varicella zoster virus (VZV) and herpes zoster virus (HZV).

Observation:

  • A 68-year-old female patient presented with herpes zoster ophthalmicus and ophthalmoplegia.
  • The patient subsequently developed cerebral venous thrombosis (CVT).

Findings:

  • This case presents a rare instance of CVT occurring in an elderly patient with herpes zoster ophthalmicus.
  • It suggests a potential, albeit infrequent, association between HZV reactivation and the development of cerebral venous thrombosis.

Implications:

  • The findings expand the spectrum of potential triggers for cerebral venous thrombosis.
  • Clinicians should consider HZV infection as a possible contributing factor in patients presenting with CVT, regardless of age.
  • Further research is warranted to elucidate the precise mechanisms linking HZV infection to thrombotic events in cerebral venous sinuses.

Keywords:
cerebral venous sinus thrombosis (cvst)headacheherpes-zoster ophthalmicusherpes-zoster virusophthalmoplegia

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