Virus-Induced Hypercoagulable State: A Mythical Cause for Cerebral Venous Sinus Thrombosis in an Adult Male

TL;DR

This paper reports a rare case of cerebral venous sinus thrombosis in an adult male caused by a varicella-zoster virus infection.

Contribution

The novelty lies in documenting a rare complication of varicella-zoster virus in an adult leading to cerebral venous sinus thrombosis.

Findings

A 34-year-old immunocompetent male developed CVST following a varicella-zoster virus infection.

Magnetic resonance venography confirmed thrombosis in multiple cerebral venous sinuses.

The possible mechanisms include a virus-induced hypercoagulable state or direct endothelial damage.

Abstract

Chickenpox is a common childhood disease that presents with erythematous rashes. In adults, varicella can cause complications with significant morbidity. Cerebral venous sinus thrombosis (CVST) is a life-threatening condition if not promptly treated. Here, we report a rare case of CVST complicating primary varicella-zoster virus infection.

We present a case of a 34-year-old immunocompetent male with diffuse maculopapular rash and acute neurological deficit. Magnetic resonance venography revealed acute thrombosis involving the superior sagittal sinus, straight sinus, right transverse sinus, and confluence of sinuses. While arterial infarcts are well-known, venous thrombosis is less documented, particularly during active infection.

The underlying mechanism may involve a hypercoagulable state induced by the infection or direct viral invasion of the venous endothelium, leading to endothelial damage and subsequent thrombosis.

Figures