Description
Herpes zoster or shingles occurs due to reactivation of latent varicella zoster virus (VZV). The most common neurological sequel of herpes zoster is post-herpetic neuralgia. Cranial nerve palsies, meningoencephalitis, cerebellitis, zoster paresis, and vasculopathy can also ensue after reactivation of VZV. Recently, much literature has been published about VZV vasculopathy causing strokes, multifocal vasculopathy mimicking giant cell arteritis, extra cranial vasculopathy, ischemic cranial neuropathy, cerebral venous sinus thrombosis, spinal cord infarction, and peripheral thrombotic disease. However, the pathogenesis of VZV vasculopathy remains elusive and early recognition of this entity is a clinical challenge. The authors report an unusual case of cerebral venous sinus thrombosis in an elderly woman during an episode of shingles that posed a significant diagnostic dilemma.