Cerebral venous thrombosis as an extrahepatic manifestation of acute anicteric hepatitis a infection

Abstract

Among the many infective causes of cerebral venous thrombosis (CVT), viral hepatitis has been regarded as a rare associated condition. We report the case of a 31-year-old woman presenting with CVT associated with hepatitis A virus (HAV) infection, outlining probable pathogenic mechanisms. We suggest that hepatitis A serological markers should be routinely included in the investigation of cerebral venous thrombosis of unknown etiology, in nonvaccinated patients with risk factors of a recent HAV exposure.

Figure 1

Cranial computerized tomography indicating left transverse sinus thrombosis. (b) Computerized tomography angiogram indicating superior sagittal and straight sinus thrombosis. (c) Magnetic resonance venography indicating the development of collateral circulation following the cerebral venous thrombosis.

Figure 2

(a) Alanine transaminase level over days of hospitalization, in IU/L (normal values 5–40 IU/L). (b) Total billirubin level over days of hospitalization, in mg/dL (normal values 0-1 mg/dL).