Cerebral venous sinus thrombosis- a potential complication of chickenpox: Case Report

Abstract

Chickenpox(varicella) is mostly a self-limiting disease of childhood. Chickenpox-related neurological complications can occur in less than 1% of cases, of which cerebral venous sinus thrombosis is a very rare complication that may be due to primary infection, post viral hypercoagulable state or reactivation of the virus. Case presentation We reported a case of a 25-year-old male adult patient who presented with complaints of diplopia, photophobia, vomiting, and headache 10 days after the onset of chickenpox rashes. He had healed lesions with scabs over the trunk and extremities. Discussion Neurological examination was normal except for abnormal pupillary reaction and decreased visual acuity. Fundoscopy revealed papilloedema. Blood and metabolic parameters were normal. Magnetic resonance imaging showed signs suggestive of superior sagittal sinus thrombosis. MR Venography was denied by the patient due to personal reason. Inj. LMWH and Mannitol were given for 5 days followed by dabigatran. The patient reported improvement in vision and other symptoms after treatment. Conclusion- The possible link between chickenpox and cerebral venous sinus thrombosis is still not clear but some literature showed it might be due to endothelial damage by viruses and a few cases reported in the pediatric population. Some case-control studies should be targeted to find out possible associations.