Cerebral Venous Sinus Thrombosis as an Unexpected Complication of COVID-19 Pneumonia

Abstract

Coronavirus disease 2019 (COVID-19) is commonly associated with acute respiratory distress syndrome and acute cardiac and renal injuries. However, thromboembolic events are also prevalent in COVID-19. The pathogenesis of COVID-19 hypercoagulability is not well known but may be linked to the cytokine storm induced by a viral infection or endothelial damage that triggers a cascade leading to hypercoagulability. Because vascular endothelium has angiotensin-converting enzyme 2-like lung tissue, COVID-19 targets lung tissue and vascular endothelium, leading to thrombosis. We present a rare case of a young patient with COVID-19 who presented with thrombosis of the cerebral venous system managed with anticoagulation. This case highlights the need for heightened awareness of this atypical but potentially treatable complication of the COVID-19 disease spectrum.

Paraganglioma: An Unexpected Diagnosis in a Patient With Cerebral Venous Sinus Thrombosis and SARS-CoV-2 Infection

“…Although infection may be one possible cause of CVST, it is important to rule out other causes such as genetics (thrombophilia) and malignancy (particularly hematological cancers) [1][2][3][4]. In this case, the etiological study found another possible cause of the CVST.…”

“…Altered vision, aphasia, seizures and coma are less frequent symptoms [1]. When CVST is detected early, with the onset of hypocoagulation and the treatment of the underlying cause, the prognosis is favorable [1,2]. The most known risk factors are oral contraceptives, pregnancy, malignancy, infections, inflammatory diseases, trauma, surgery and other prothrombotic conditions like genetic or acquired thrombophilias [1][2][3][4][5].…”

“…It has been described an increased number of venous thromboembolism (VTE) and deep venous thrombosis, but less cases of CVST in SARS-CoV-2 infected patients [2].…”

Neurological complications of COVID-19 in pediatric patients require comprehensive evaluation

“…It is conceivable that the shunt function was impaired due to an altered composition of the CSF resulting in increased intracranial pressure. It is also conceivable that the patient had experienced venous sinus thrombosis (VST), a frequent complication of SARS-CoV-2 infections (Abdulgayoom et al 2021). We should be informed about the results of magnetic resonance venography (MRV) and the D-dimer levels.…”

COVID-19 Vaccine-Induced Cerebral Sinus Thrombosis: Coincidence vs. Cause?

“…Cerebral venous sinus thrombosis (CVST) is less prevalent than most other causes of stroke (It accounts for 0.5%-1% of all stroke causes). Still, it is more challenging to identify, as it has been found to have a broader clinical scope than previously thought [ 1 ]. Hereditary prothrombotic disorders, antiphospholipid antibody syndrome, cancer, pregnancy, autoimmune illnesses, and infections are all common causes of CVST [ 2 ].…”