Management of Cavernous Sinus Thrombosis Following Herpes Zoster Ophthalmicus

Yusuf Mehkri; Jeff A Valisno; Lorena Figueredo Rivas; Jairo Hernandez; Varun Jain; Aisha Elfasi; Justin De Prey; Calvin Hu; Bedirhan Tarhan; Ibrahim S Tuna; Hans H Shuhaiber

doi:10.7759/cureus.21036

Management of Cavernous Sinus Thrombosis Following Herpes Zoster Ophthalmicus

Cureus. 2022 Jan 8;14(1):e21036. doi: 10.7759/cureus.21036. eCollection 2022 Jan.

Affiliations

¹ Department of Neurosurgery, University of Florida College of Medicine, Gainesville, USA.
² Department of Neurology, University of Florida College of Medicine, Gainesville, USA.
³ Department of Radiology, University of Florida College of Medicine, Gainesville, USA.

Abstract

Herpes zoster opthalmicus (HZO) is the reactivation of latent varicella zoster virus (VZV) within the ophthalmic branch of the trigeminal ganglion (V1). Common complications are postherpetic neuralgia and vasculopathy. Here, we report a rare case of a 47-year-old female presenting with HZO and aseptic cavernous sinus thrombosis (CST). Early screening for rare and deadly complications such as CST using CT cerebral venography (CTV) and magnetic resonance venography (MRV), as was done, is crucial to detection at earlier stages when intervention is most effective. Anticoagulation therapy was promptly started, and the patient's symptoms continued to improve during the hospital stay.

Keywords: aseptic cavernous sinus thrombosis; herpes simplex; herpes simplex ophthalmicus; herpes zoster meningitis; varicella-zoster virus.

Publication types

Case Reports