tetano
Editor, Senior Moderator
J Stroke Cerebrovasc Dis
. 2020 Nov 6;30(1):105434.
doi: 10.1016/j.jstrokecerebrovasdis.2020.105434. Online ahead of print.
Cerebral Venous Sinus Thrombosis in COVID-19 Infection: A Case Series and Review of The Literature
Katarina Dakay[SUP] 1 [/SUP], Jared Cooper[SUP] 2 [/SUP], Jessica Bloomfield[SUP] 3 [/SUP], Philip Overby[SUP] 4 [/SUP], Stephan A Mayer[SUP] 5 [/SUP], Rolla Nuoman[SUP] 6 [/SUP], Ramandeep Sahni[SUP] 7 [/SUP], Edwin Gulko[SUP] 8 [/SUP], Gurmeen Kaur[SUP] 9 [/SUP], Justin Santarelli[SUP] 10 [/SUP], Chirag D Gandhi[SUP] 11 [/SUP], Fawaz Al-Mufti[SUP] 12 [/SUP]
Affiliations
Abstract
SARS-CoV-2, the virus responsible for novel Coronavirus (COVID-19) infection, has recently been associated with a myriad of hematologic derangements; in particular, an unusually high incidence of venous thromboembolism has been reported in patients with COVID-19 infection. It is postulated that either the cytokine storm induced by the viral infection or endothelial damage caused by viral binding to the ACE-2 receptor may activate a cascade leading to a hypercoaguable state. Although pulmonary embolism and deep venous thrombosis have been well described in patients with COVID-19 infection, there is a paucity of literature on cerebral venous sinus thrombosis (cVST) associated with COVID-19 infection. cVST is an uncommon etiology of stroke and has a higher occurrence in women and young people. We report a series of three patients at our institution with confirmed COVID-19 infection and venous sinus thrombosis, two of whom were male and one female. These cases fall outside the typical demographic of patients with cVST, potentially attributable to COVID-19 induced hypercoaguability. This illustrates the importance of maintaining a high index of suspicion for cVST in patients with COVID-19 infection, particularly those with unexplained cerebral hemorrhage, or infarcts with an atypical pattern for arterial occlusive disease.
Keywords: COVID-19; Coronavirus; Hypercoaguability; Stroke; Venous sinus thrombosis; Venous thromboembolism.
. 2020 Nov 6;30(1):105434.
doi: 10.1016/j.jstrokecerebrovasdis.2020.105434. Online ahead of print.
Cerebral Venous Sinus Thrombosis in COVID-19 Infection: A Case Series and Review of The Literature
Katarina Dakay[SUP] 1 [/SUP], Jared Cooper[SUP] 2 [/SUP], Jessica Bloomfield[SUP] 3 [/SUP], Philip Overby[SUP] 4 [/SUP], Stephan A Mayer[SUP] 5 [/SUP], Rolla Nuoman[SUP] 6 [/SUP], Ramandeep Sahni[SUP] 7 [/SUP], Edwin Gulko[SUP] 8 [/SUP], Gurmeen Kaur[SUP] 9 [/SUP], Justin Santarelli[SUP] 10 [/SUP], Chirag D Gandhi[SUP] 11 [/SUP], Fawaz Al-Mufti[SUP] 12 [/SUP]
Affiliations
- PMID: 33190109
- DOI: 10.1016/j.jstrokecerebrovasdis.2020.105434
Abstract
SARS-CoV-2, the virus responsible for novel Coronavirus (COVID-19) infection, has recently been associated with a myriad of hematologic derangements; in particular, an unusually high incidence of venous thromboembolism has been reported in patients with COVID-19 infection. It is postulated that either the cytokine storm induced by the viral infection or endothelial damage caused by viral binding to the ACE-2 receptor may activate a cascade leading to a hypercoaguable state. Although pulmonary embolism and deep venous thrombosis have been well described in patients with COVID-19 infection, there is a paucity of literature on cerebral venous sinus thrombosis (cVST) associated with COVID-19 infection. cVST is an uncommon etiology of stroke and has a higher occurrence in women and young people. We report a series of three patients at our institution with confirmed COVID-19 infection and venous sinus thrombosis, two of whom were male and one female. These cases fall outside the typical demographic of patients with cVST, potentially attributable to COVID-19 induced hypercoaguability. This illustrates the importance of maintaining a high index of suspicion for cVST in patients with COVID-19 infection, particularly those with unexplained cerebral hemorrhage, or infarcts with an atypical pattern for arterial occlusive disease.
Keywords: COVID-19; Coronavirus; Hypercoaguability; Stroke; Venous sinus thrombosis; Venous thromboembolism.