Cerebral venous sinus thrombosis as a complication of COVID-19 infection – A case report

Abstract

Introduction and importance Severe acute respiratory distress syndrome coronavirus 2 is the causative agent of COVID-19 (Coronavirus 2019) infection. Although symptoms are usually associated with the respiratory system, its neurological involvement should not be underestimated. The most common cerebrovascular complication following the infection is ischemic stroke however, CVST (Cerebral Venous Sinus Thrombosis) has been reported. Presentation of case We report a unique case of a young patient who had a history of headache and abnormal body movement immediately after COVID-19 infection. His brain Computed tomography scan and Magnetic Resonance Imaging (MRI) showed typical images of CVST. He was admitted and treated with Low Molecular weight heparin. Discussion CVST is a rare form of stroke which may have devastating complications. The diagnosis is clinically challenging due to its non-specific presentation like headache and altered sensorium alone. Inflammatory process and hypoxic state after the virus infection may favor the hypercoagulable state in CVST. Our patient did not have any other predisposing factor for a hypercoagulable state other than the COVID-19 infection.MRI and venography and computed tomographic venography are the preferred modalities. The Patient is generally treated with anticoagulation therapy. Conclusion High index of suspicion of CVST is necessary when a patient presents with unexplained neurological manifestation following a recent COVID-19 infection to prevent from life-threatening complications. Furthermore, clinicians should not underestimate the multisystem involvement of COVID-19.

Brain MRI Findings In Children With Convulsions Secondary to Covid-19 Infection

“…Poyiadji et al (13) reported the MRI findings of an adult female patient who developed acute necrotizing hemorrhagic encephalopathy associated with COVID-19. Rajbhandari et al (14) reported that cerebral sinus vein thrombosis may develop as a complication of COVID-19 infection in young patients. In a study of paediatric patients with COVID-19 infection, Sun et al (15) reported clinical conditions such as septic shock, multi-organ failure, intussusception, toxic encephalopathy, status epilepticus and disseminated intravascular coagulation as complications.…”

Multi-organ microphysiological system: A new paradigm for COVID-19 research

“…Vascular endothelial cells can participate in the recruitment of inflammatory cells, and are themselves a significant source of pro-inflammatory cytokines. In addition, cerebrovascular thrombosis contributes to the brain hypoxic injury in some individuals with COVID-19 ( Baldini et al, 2021 ; Rajbhandari et al, 2022 ; Sashindranath and Nandurkar, 2021 ). With regards to immune system, accumulating clinical evidence shows an abnormal and uncontrolled production of cytokines (cytokine storm) in critically ill COVID-19 patients ( Hirawat et al, 2021 ; Hu et al, 2021 ; Wang et al, 2021 ).…”