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DOI: 10.1055/s-0042-1750388
Long-Delayed Manifestation of COVID-19 Coagulopathy Presenting with Severe Cerebral Venous Thrombosis Causes Massive Brain Hemorrhage
Abstract
COVID-19 infection causes coagulopathy, which may lead to cerebral venous thrombotic (CVT) event. It usually occurs in patients with higher severity level of infection and manifests mostly within a month after the infection. However, in rare cases, the CVT may happen long after the infection and unrelated to the degree of the infection severity. We present the case of a previously healthy 62-year-old male patient with very mild COVID-19 symptoms that resolved in 3 weeks of home isolation treatment. Immediately after the infection, he developed hypercoagulability and was treated routinely with a novel oral anti-coagulant drug. Four months after the infection, he developed a worsening headache which, in several days, deteriorated to cause reduction in his consciousness level. Imaging showed a right temporoparietooccipital massive brain hemorrhage with right transverse and sigmoid sinus thrombosis. Emergency decompressive craniectomy was performed and the patient recovery was excellent. In patients with a hypercoagulable state after COVID-19 infection, the possibility of CVT event should be observed. It may not be related to the severity of the infection, and it may happen long after the infection.
Publikationsverlauf
Artikel online veröffentlicht:
24. August 2022
© 2022. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Di Minno A, Ambrosino P, Calcaterra I, Di Minno MND. COVID-19 and venous thromboembolism: a meta-analysis of literature studies. Semin Thromb Hemost 2020; 46 (07) 763-771
- 2 Klok FA, Kruip MJHA, van der Meer NJM. et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res 2020; 191: 145-147
- 3 Middeldorp S, Coppens M, van Haaps TF. et al. Incidence of venous thromboembolism in hospitalized patients with COVID-19. J Thromb Haemost 2020; 18 (08) 1995-2002
- 4 Romoli M, Jelcic I, Bernard-Valnet R. et al; Infectious Disease Panel of the European Academy of Neurology A systematic review of neurological manifestations of SARS-CoV-2 infection: the devil is hidden in the details. Eur J Neurol 2020; 27 (09) 1712-1726
- 5 Devasagayam S, Wyatt B, Leyden J, Kleinig T. Cerebral venous sinus thrombosis incidence is higher than previously thought: a retrospective population-based study. Stroke 2016; 47 (09) 2180-2182
- 6 Tu TM, Goh C, Tan YK. et al. Cerebral venous thrombosis in patients with COVID-19 infection: a case series and systematic review. J Stroke Cerebrovasc Dis 2020; 29 (12) 105379
- 7 Baldini T, Asioli GM, Romoli M. et al. Cerebral venous thrombosis and severe acute respiratory syndrome coronavirus-2 infection: a systematic review and meta-analysis. Eur J Neurol 2021; 28 (10) 3478-3490
- 8 Cavalcanti DD, Raz E, Shapiro M. et al. Cerebral venous thrombosis associated with COVID-19. Am J Neuroradiol 2020; 41 (08) 1370-1376
- 9 Nwajei F, Anand P, Abdalkader M. et al. Cerebral venous sinus thromboses in patients with SARS-CoV-2 infection: three cases and a review of the literature. J Stroke Cerebrovasc Dis 2020; 29 (12) 105412
- 10 Ostovan VR, Foroughi R, Rostami M. et al. Cerebral venous sinus thrombosis associated with COVID-19: a case series and literature review. J Neurol 2021; 268 (10) 3549-3560
- 11 Celi A, Cianchetti S, Dell'Omo G, Pedrinelli R. Angiotensin II, tissue factor and the thrombotic paradox of hypertension. Expert Rev Cardiovasc Ther 2010; 8 (12) 1723-1729
- 12 Forrester SJ, Booz GW, Sigmund CD. et al. Angiotensin II signal transduction: an update on mechanisms of physiology and pathophysiology. Physiol Rev 2018; 98 (03) 1627-1738
- 13 Goeijenbier M, van Wissen M, van de Weg C. et al. Review: viral infections and mechanisms of thrombosis and bleeding. J Med Virol 2012; 84 (10) 1680-1696
- 14 Gupta N, Zhao YY, Evans CE. The stimulation of thrombosis by hypoxia. Thromb Res 2019; 181: 77-83
- 15 Miesbach W, Makris M. COVID-19: coagulopathy, risk of thrombosis, and the rationale for anticoagulation. Clin Appl Thromb Hemost 2020; 26: 1076029620938149
- 16 Coutinho JM, Zuurbier SM, Aramideh M, Stam J. The incidence of cerebral venous thrombosis: a cross-sectional study. Stroke 2012; 43 (12) 3375-3377
- 17 Silvis SM, de Sousa DA, Ferro JM, Coutinho JM. Cerebral venous thrombosis. Nat Rev Neurol 2017; 13 (09) 555-565
- 18 Gulati D, Strbian D, Sundararajan S. Cerebral venous thrombosis: diagnosis and management. Stroke 2014; 45 (02) e16-–e18
- 19 Medicherla CB, Pauley RA, de Havenon A, Yaghi S, Ishida K, Torres JL. Cerebral venous sinus thrombosis in the COVID-19 pandemic. J Neuroophthalmol 2020; 40 (04) 457-462
- 20 Mowla A, Shakibajahromi B, Shahjouei S. et al. Cerebral venous sinus thrombosis associated with SARS-CoV-2; a multinational case series. J Neurol Sci 2020; 419: 117183
- 21 Field TS, Hill MD. Cerebral venous thrombosis. Stroke 2019; 50 (06) 1598-1604
- 22 Wasay M, Khan M, Rajput HM. et al. New oral anticoagulants versus warfarin for cerebral venous thrombosis: a multi-center, observational study. J Stroke 2019; 21 (02) 220-223