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Cureus. 2017 Sep 16;9(9):e1693. doi: 10.7759/cureus.1693.

A Unique Case of Acute Cerebral Venous Sinus Thrombosis Secondary to Primary Varicella Zoster Virus Infection.

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Department of Internal Medicine, Shifa International Hospital, Islamabad, Pakistan.
Shifa College of Medicine, Shifa International Hospital, Islamabad, Pakistan.
Medicine, Shifa International Hospital, Islamabad, Pakistan.
Department of Neurology, Shifa International Hospital, Islamabad, Pakistan.


Primary varicella zoster virus (VZV) infection, predominantly in the pediatric population, presents with pyrexia and a classic pruritic vesicular rash. In adults, although less common, it is more severe and linked to more complications. Neurological complications, which account for less than 1% of all VZV complications, include meningitis, encephalitis, arterial vasculopathy, and venous thrombosis. We present a case of a 39-year-old male who developed extensive cerebral venous sinus thrombosis following primary VZV infection. Venous thrombosis in VZV has been suggested to be caused by autoantibodies against protein S, pre-existing hypercoagulability, or endothelial damage. The patient was acutely managed using intravenous acyclovir and heparin. Long-term anticoagulation therapy with warfarin was continued after discharge. We concluded that clinicians should be aware of the rare complications of this common pathology so that a timely diagnosis can be made, followed by prompt management. Further studies need to be done to better understand acute cerebral venous sinus thrombosis secondary to VZV.


cerebral venous thrombosis; chickenpox; cvst; cvt; varicella; venous thrombosis; vzv

Conflict of interest statement

The authors have declared that no competing interests exist.

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