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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2020; 78(07): 454-455
DOI: 10.1590/0004-282X20200057
Neurological Image

Acute ischemic stroke in a patient with COVID-19

Acidente vascular cerebral isquêmico agudo em paciente com COVID-19
Carla Franco Costa LIMA 
1   Hospital Geral de Fortaleza, Departamento de Radiologia, Fortaleza CE, Brasil.
,
Jorge Luis Bezerra HOLANDA 
1   Hospital Geral de Fortaleza, Departamento de Radiologia, Fortaleza CE, Brasil.
,
Mariana Santos Leite PESSOA 
1   Hospital Geral de Fortaleza, Departamento de Radiologia, Fortaleza CE, Brasil.
,
Pablo Picasso de Araújo COIMBRA 
1   Hospital Geral de Fortaleza, Departamento de Radiologia, Fortaleza CE, Brasil.
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Coronavirus disease 2019 (COVID-19) seems to be associated with a strong thrombotic tendency, due to different mechanisms still unknown[1], which may predispose to arterial and venous thrombosis[1],[2],[3]. However, risk estimates for these complications are still preliminary[1].

We report a case of an 89-year-old female patient admitted to the emergency room of a tertiary hospital with right hemiparesis, aphasia, and dysarthria. Cranial computed tomography (CT) ([Figs. 1],[2]) and cranial CT angiography ([Fig. 3]) showed findings suggestive of acute ischemic stroke in the area of the left middle cerebral artery. The patient declared having flu-like symptoms for about two weeks, and chest CT findings were suggestive of viral infection ([Fig. 4]). The rapid test was performed, and the result was positive for SARS-CoV-2.

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Figure 1 Axial image of cranial computed tomography showing an area of cortico-subcortical hypoattenuation with loss of white-gray differentiation in the left insular region (arrow).
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Figure 2 Axial (A) and coronal (B) images of cranial computed tomography compatible with hyperdensity in the left middle cerebral artery (arrows).
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Figure 3 Cranial computed tomography angiography images in 3D volume rendering reconstruction (A) and axial maximum intensity projection reconstruction (B) showing interruption of contrast flow in the M2 segment of the left middle cerebral artery (arrows).
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Figure 4 Axial tomography image of the chest with lung window demonstrating peripheral opacity with ground-glass attenuation in the right lung (arrows).


Publication History

Received: 26 May 2020

Accepted: 29 May 2020

Article published online:
13 June 2023

© 2020. Academia Brasileira de Neurologia. 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 commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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