Cerebral Venous Sinus Thrombosis (CVST) in COVID 19 Pandemic
Mohamed Ahmed Shafik1* and Noha A Aoueldahab2
1Lecturer of Neurology, Ain Shams University, Cairo, Egypt
2Assistant Lecturer of Radiology, Ain Shams University, Cairo, Egypt
*Corresponding Author: Mohamed Ahmed Shafik, Lecturer of Neurology, Ain Shams University, Cairo, Egypt.
Received: August 25, 2021; Published:00-00
Abstract
We present a case of CVST complicating COVID19 infection in a 58 year-old female with first ever generalized tonic clonic convulsions. The patient has a past medical history of bilateral frontal lobes tumor excision, COVID 19 previous infection and recent history of COVID19 adenovirus vaccination. The first presentation and the CT Brain finding of residual encephalomalacia did not prompt further workup. However; fever with new positive PCR-SARS-COV-2, unimproved patient’s conscious level and upcoming neurologic sign of lateralization mandate further brain imaging revealing cerebral venous sinuses thrombosis, cortical and subarachnoid venous haemorrhages. The evidenced hypercoagulable state associated with COVID19 infection together with the reported thrombotic-thrombocytopenic complication of adenovirus COVID19 vaccines were two important key players. Therapeutic anticoagulation was the main line of treatment.
Keywords: Cerebral Venous Sinus Thrombosis (CVST); COVID 19 Pandemic
- Tian S., et al. “Characteristics of COVID-19 infection in Beijing”. Journal of Infection 4 (2020): 401-406.
- Frontera JA., et al. “A prospective study of neurologic disorders in hospitalized patients with COVID-19 in New York City”. Neurology 96 (2021): e575-e586.
- Tsai LK., et al. “Neurological manifestations in severe acute respiratory syndrome”. Acta Neurol Taiwan 3 (2005): 113-119.
- Connors JM and Levy JH. “Thrombo inflammation and the hypercoagulability of COVID-19”. Journal of Thrombosis and Haemostasis7 (2020): 1559-1561.
- Zuo Y., et al. “Prothrombotic autoantibodies in serum from patients hospitalized with COVID-19”. Science Translational Medicine570 (2020): eabd3876.
- Li Y., et al. “Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study”. Stroke and Vascular Neurology3 (2020): 279-284.
- Berlin DA., et al. “Severe Covid-19”. The New England Journal of Medicine25 (2020): 2451-2460.
- Dakay K., et al. “Cerebral venous sinus thrombosis in COVID-19 infection: a case series and review of the literature”. Journal of Stroke and Cerebrovascular Diseases 1 (2021): 105434.
- Cannac O., et al. “Critical illness-associated cerebral microbleeds in COVID-19 acute respiratory distress syndrome”. Neurology11 (2020): 498-499.
- Agarwal S., et al. “Cerebral microbleeds and leukoencephalopathy in critically ill patients with COVID-19”. Stroke9 (2020): 2649-2655.
- Conklin J., et al. “Cerebral microvascular injury in severeCOVID-19”. Med Rxiv (2020).
- Connors JM and Levy JH. “Thrombo inflammation and the hypercoagulability of COVID-19”. Journal of Thrombosis and Haemostasis7 (2020): 1559-1561.
- Greinacher A. “Thrombotic Thrombocytopenia after ChAdOX1 nCov-19 Vaccination”. The New England Journal of Medicine (2021).
- Schultz N. “Thrombosis and Thrombocytopenia after ChAdOX1 nCov-19 Vaccination”. The New England Journal of Medicine (2021).
- Pai M. “Vaccine-induced prothrombotic immune thrombocytopenia VIPIT following AstraZeneca COVID-19 vaccination”. Sceince Breifs of the Ontario COVID-19Sceince Advisory Table17 (2021).
- See I., et al. “US case reports of cerebral venous sinus thrombosis with thrombocytopenia after Ad26.COV2”. S vaccination24 (2021): 2448-2456.
- Scully M., et al. “Pathologic antibodies to platelet factor 4 after ChAdOx1 nCoV-19 vaccination”. The New England Journal of Medicine 384 (2021): 2201-2211.