Hemorrhagic stroke and cerebral venous thrombosis: rare neurological sequelae of chickenpox infection

Mehta, Anuradha; Arora, Ananya; Sharma, Manoj; Malik, Rupali; Porwal, Yogesh Chandra

doi:10.4103/aian.aian_421_17

Cited by 8 publications

(5 citation statements)

References 13 publications

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“…Some concerns have also been raised about cases of CVST with thrombocytopenia following COVID-19 vaccination with AstraZeneca [8]. Although not widely known, CVST associated with VZV and HZV has been reported in several case reports [9][10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

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Cerebral Venous Sinus Thrombosis Complicating Herpes Zoster Ophthalmicus Ophthalmoplegia

Ali,

Obiechina,

Ling

et al. 2024

Cureus

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Cerebral venous sinus thrombosis (CVST) is a rare cause of strokes and is most common in younger patients particularly those less than 50 years of age. It is more common in females than in males and is known to be associated with pregnancy, puerperium, oral contraception, congenital and acquired thrombophilia, and malignancy. Less commonly, it has been shown to be associated with infections and more recently has been found to be associated with COVID-19 infection with thrombocytopenia and the COVID-19 vaccine AstraZeneca. Rare cases have been reported in association with varicella zoster virus (VZV) infection (chickenpox) and its reactivated version of herpes zoster virus (HZV) infection (shingles). We report the case of a 68-year-old lady with herpes zoster ophthalmicus ophthalmoplegia who developed cerebral venous thrombosis (CVT).

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Section: Discussionmentioning

confidence: 99%

“…VZV and HZV have been linked to vasculopathy and arterial strokes and, less often, venous strokes, such as CVST and cerebral venous thrombosis (CVT) [14,20]. The mechanisms behind this association are not well understood [18].…”

Section: Discussionmentioning

confidence: 99%

Cerebral Venous Sinus Thrombosis Complicating Herpes Zoster Ophthalmicus Ophthalmoplegia

Ali,

Obiechina,

Ling

et al. 2024

Cureus

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“…Of the other 5 cases, 3 had mild pleocytosis and a mild increase in protein [ 19 , 23 ]; among these, only 1 confirmed the presence of the virus in the CSF by PCR. Two cases had a slight increase in protein in the CSF [ 16 , 20 ], with positive IgM in CSF in only 1 of them. These results indicate that VrCVST can occur as a complication of varicella, even without central nervous system (CNS) infection.…”

Section: Discussionmentioning

confidence: 99%

Chronic Headache and Cerebral Venous Sinus Thrombosis Due to Varicella Zoster Virus Infection: A Case Report and Review of the Literature

et al. 2021

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Patient: Male, 20-year-old Final Diagnosis: Cerebral venous sinus thrombosis • varicella zoster virus infection Symptoms: Fever • headache • skin rash Medication: — Clinical Procedure: — Specialty: Infectious Diseases • Rheumatology Objective: Unusual clinical course Background: Varicella zoster virus (VZV) infection causes 2 clinically distinct forms of the disease: varicella (chickenpox) and herpes zoster (shingles). Primary VZV infection results in the diffuse vesicular rash of varicella, or chickenpox. Endogenous reactivation of latent VZV typically results in a localized skin infection known as herpes zoster, or shingles. The infection usually manifests as a self-limited disease. However, it can be associated with various neurological complications such as encephalitis, meningitis, ventriculitis, cerebellar ataxia, ischemic or hemorrhagic, and, rarely, cerebral venous sinus thrombosis (CVST). This report presents a case of cerebral venous sinus thrombosis due to varicella zoster virus infection in a 20-year-old Nepalese man who presented to the Emergency Department with headache. Case Report: A 20-year-old Nepalese male patient presented to the Emergency Department with headache of 10 day’s duration. Five days prior to that, he had a diffuse pruritic skin rash. Examination as well as serology confirmed the presence of primary varicella infection. Computed tomography (CT) and magnetic resonance venography (MRV) demonstrated CVST. Thrombophilia workup revealed a transient elevation of antiphospholipid serology. Shortly after admission, the patient had a transient seizure. He was treated with acyclovir, levetiracetam, and anticoagulation. A comprehensive literature review of similar cases was performed to establish a link between thrombotic complications and primary VZV infection and to formulate possible mechanistic pathways. Conclusions: This report shows that primary VSV infection can be associated with vasculopathy and CVST. Physicians should recognize this serious complication, which should be diagnosed and treated without delay.

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“…4 The various proposed mechanisms of these complications include direct neurological damage, immune-mediated damage and vasculopathy. 5 Isolated facial nerve paralysis is a relatively rare complication of varicella. 6 , 7 In a previous study, it was reported in 8.3% of the patients.…”

Section: Discussionmentioning

confidence: 99%

Isolated Lower Motor Neuron Facial Nerve Palsy in a Patient of Varicella: A Case Report

2020

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Varicella or chickenpox is usually regarded as a self-limiting disease, but occasionally it may leadto irreversible neurological complications. Isolated lower motor neuron facial nerve palsy is a rarecomplication of varicella, with very few cases reported from the Indian subcontinent. We report onesuch case, where the patient developed facial palsy after healing of cutaneous lesions and recoveredcompletely with oral corticosteroids.

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Hemorrhagic stroke and cerebral venous thrombosis: rare neurological sequelae of chickenpox infection

Cited by 8 publications

References 13 publications

Cerebral Venous Sinus Thrombosis Complicating Herpes Zoster Ophthalmicus Ophthalmoplegia

Cerebral Venous Sinus Thrombosis Complicating Herpes Zoster Ophthalmicus Ophthalmoplegia

Chronic Headache and Cerebral Venous Sinus Thrombosis Due to Varicella Zoster Virus Infection: A Case Report and Review of the Literature

Isolated Lower Motor Neuron Facial Nerve Palsy in a Patient of Varicella: A Case Report

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