tetano
Editor, Senior Moderator
Cureus
. 2021 Nov 20;13(11):e19763.
doi: 10.7759/cureus.19763. eCollection 2021 Nov.
Cerebral Venous Infarct After Recovery From COVID-19 Pneumonia
Mohanned F Alfahhad[SUP] 1 [/SUP], Saeed S Alghamdi[SUP] 2 [/SUP], Osama A Alzahrani[SUP] 2 [/SUP], Saleh K Aldakhil[SUP] 3 [/SUP], Abdulaziz A Algarni[SUP] 3 [/SUP], Ismail A Juraybi[SUP] 4 [/SUP], Thekra M Alsalmi[SUP] 5 [/SUP], Amjad S Alsulaihebi[SUP] 6 [/SUP], Mawaddah K Yousef[SUP] 1 [/SUP], Abdulaziz S Almuhaisen[SUP] 7 [/SUP], Hamoud M Alfawzan[SUP] 8 [/SUP], Fatema M Alsalehi[SUP] 9 [/SUP], Raghad N Alsaeed[SUP] 10 [/SUP], Hareth H Alharthi[SUP] 6 [/SUP], Faisal Al-Hawaj[SUP] 11 [/SUP]
Affiliations
Abstract
The coronavirus disease 2019 (COVID-19) may have multisystem organ involvement. Thrombotic events are well-recognized complications of COVID-19. Such complications may include the pulmonary, renal, and other organs vasculature. The risk of coagulopathy is usually related to the severity of COVID-19 pneumonia. Few cases suggested that the coagulopathy risk may persist for some period after the recovery from COVID-19. We report the case of a middle-aged man with severe COVID-19 pneumonia that required seven days of endotracheal intubation and mechanical ventilation who presented with headache and left-sided weakness that occurred three days after his discharge. A computed tomography scan was performed to rule out intracranial hemorrhage before initiating the thrombolytic therapy. The scan demonstrated hemorrhage in the right temporal lobe with surrounding vasogenic edema along with density in the right transverse sinus. Subsequently, computed tomography venography was performed and demonstrated the filling defect representing right sigmoid venous sinus thrombosis. The patient received conservative measures in the form of intravenous hydration, anticoagulation, analgesics, and anticonvulsants. During the hospital stay, the patient had improvement in his symptom and mild neurological deficit persisted. The case highlighted that risk of thrombotic complications in COVID-19 pneumonia may persist for some period after the recovery from the disease. Hence, thromboprophylaxis may be indicated in selected patients with a risk of thrombotic events after their recovery from severe COVID-19.
Keywords: case report; cerebral venous sinus thrombosis (cvst); computed tomography; coronavirus disease 2019 (covid-19); headache.
. 2021 Nov 20;13(11):e19763.
doi: 10.7759/cureus.19763. eCollection 2021 Nov.
Cerebral Venous Infarct After Recovery From COVID-19 Pneumonia
Mohanned F Alfahhad[SUP] 1 [/SUP], Saeed S Alghamdi[SUP] 2 [/SUP], Osama A Alzahrani[SUP] 2 [/SUP], Saleh K Aldakhil[SUP] 3 [/SUP], Abdulaziz A Algarni[SUP] 3 [/SUP], Ismail A Juraybi[SUP] 4 [/SUP], Thekra M Alsalmi[SUP] 5 [/SUP], Amjad S Alsulaihebi[SUP] 6 [/SUP], Mawaddah K Yousef[SUP] 1 [/SUP], Abdulaziz S Almuhaisen[SUP] 7 [/SUP], Hamoud M Alfawzan[SUP] 8 [/SUP], Fatema M Alsalehi[SUP] 9 [/SUP], Raghad N Alsaeed[SUP] 10 [/SUP], Hareth H Alharthi[SUP] 6 [/SUP], Faisal Al-Hawaj[SUP] 11 [/SUP]
Affiliations
- PMID: 34938638
- PMCID: PMC8686011
- DOI: 10.7759/cureus.19763
Abstract
The coronavirus disease 2019 (COVID-19) may have multisystem organ involvement. Thrombotic events are well-recognized complications of COVID-19. Such complications may include the pulmonary, renal, and other organs vasculature. The risk of coagulopathy is usually related to the severity of COVID-19 pneumonia. Few cases suggested that the coagulopathy risk may persist for some period after the recovery from COVID-19. We report the case of a middle-aged man with severe COVID-19 pneumonia that required seven days of endotracheal intubation and mechanical ventilation who presented with headache and left-sided weakness that occurred three days after his discharge. A computed tomography scan was performed to rule out intracranial hemorrhage before initiating the thrombolytic therapy. The scan demonstrated hemorrhage in the right temporal lobe with surrounding vasogenic edema along with density in the right transverse sinus. Subsequently, computed tomography venography was performed and demonstrated the filling defect representing right sigmoid venous sinus thrombosis. The patient received conservative measures in the form of intravenous hydration, anticoagulation, analgesics, and anticonvulsants. During the hospital stay, the patient had improvement in his symptom and mild neurological deficit persisted. The case highlighted that risk of thrombotic complications in COVID-19 pneumonia may persist for some period after the recovery from the disease. Hence, thromboprophylaxis may be indicated in selected patients with a risk of thrombotic events after their recovery from severe COVID-19.
Keywords: case report; cerebral venous sinus thrombosis (cvst); computed tomography; coronavirus disease 2019 (covid-19); headache.