Case reports of cerebral sinus venous thrombosis in COVID-19 patients

The Egyptian Journal of Neurology, Psychiatry and Neurosurgery

Prysta Aderlia Sitanggang¹  Kumara Tini²  Ida Ayu Sri Wijayanti²  Dewa Putu Gde Purwa Samatra²  Ni Made Susilawathi²  Putu Utami Dewi³ 

[1] Departement of Neurology, Udayana University, Sanglah General Hospital, Jalan Kesehatan No.1, Denpasar, Bali, Indonesia;Department of Neurology, Faculty of Medicine, Universitas Udayana, Universitas Udayana Hospital, Jalan Rumah Sakit Universitas Udayana No.1, Jimbaran, South Kuta, Badung, Bali, Indonesia;Department of Radiology, Faculty of Medicine, Universitas Udayana, Universitas Udayana Hospital, Jalan Rumah Sakit Universitas Udayana No.1, Jimbaran, South Kuta, Badung, Bali, Indonesia;

关键词: COVID 19;    CSVT;    Thrombogenesis;    Coagulation cascade;   

DOI  :  10.1186/s41983-021-00335-y

来源: Springer

【 摘 要 】

BackgroundCoronavirus disease 2019 (COVID-19) pandemic has started in December 2019 and still ongoing. The disease has been expanding rapidly with a high variety of phenotypes from asymptomatic, mild respiratory tract infection, multiple organ system dysfunction, and death. Neurological manifestations also appear in patients with COVID-19, such as headache, seizures, a decrease of consciousness, and paralysis. The hypercoagulable state in patients with COVID-19 is associated with the thromboembolic incident including ischemic strokes, venous thromboembolism, pulmonary artery embolism, and many further. Cerebral sinus venous thrombosis (CSVT) is a rare neurovascular emergency that is often found in critically ill patients. We report two cases of CSVT with different onsets, neurologic manifestations, and prognoses.Case presentationTwo cases of cerebral sinus venous thrombosis in COVID-19 patients were reported, following respiratory, hematology, and coagulation disarrangements, which was triggered by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The first patient, which was presented with a seizure, had hypertension and diabetes mellitus as comorbidities. The latter case had no comorbidity but showed more severe presentations of COVID-19 such as brain and lung thrombosis, although already had several days of intravenous anticoagulant administrations. These two cases also have a different course of disease and outcomes, which were interesting topics to study.ConclusionsCSVT is one of the neurological complications of the COVID-19 when the brainstem venous drainage is involved. Despite successful alteration to the negative result of SARS-CoV-2 through the rt-PCR test, thrombogenesis and coagulation cascade continuing. Therefore, a high level of neutrophil to lymphocyte ratio (NLR), D-dimer, fibrinogen, and C-reactive protein (CRP) are paramount indicators of poor prognosis.

【 授权许可】

CC BY