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Extensive cerebral venous sinus thrombosis: a potential complication in a patient with COVID-19 disease

Paul Bolaji, Babatunde Kukoyi, Nasar Ahmad, Chris Wharton

2020BMJ Case Reports55 citationsDOIOpen Access PDF

Abstract

A 63-year-old man was admitted with left-sided weakness and subsequent focal seizures following a recent diagnosis of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia in a nearby hospital. He developed status epilepticus and became comatose, requiring intensive care unit admission for invasive ventilation. Imaging done at admission confirmed extensive cerebral venous sinus thrombosis (CVST) with bilateral venous cortical infarcts and acute cortical haemorrhage. No known risk factor for CVST could be identified. He improved with anticoagulation and antiepileptic therapy. He was subsequently transferred to an inpatient rehabilitation facility. Although Coronavirus disease 19 (COVID-19) infection has been previously associated with thrombotic complications, these mostly relate to the pulmonary vasculature. We present this case as a potential association between CVST and COVID-19 infection.

Topics & Concepts

MedicineStatus epilepticusCerebral venous sinus thrombosisPneumoniaIntensive care unitVenous thrombosisMechanical ventilationCoronavirus disease 2019 (COVID-19)ThrombosisComplicationIntensive care medicineAnesthesiaDiseaseSurgeryInternal medicineEpilepsyInfectious disease (medical specialty)PsychiatryCerebral Venous Sinus ThrombosisVenous Thromboembolism Diagnosis and ManagementIntracerebral and Subarachnoid Hemorrhage Research