tetano
Editor, Senior Moderator
Neurol Ther
. 2021 Oct 29.
doi: 10.1007/s40120-021-00294-9. Online ahead of print.
Simultaneous Occurrence of Cerebral Venous Sinus Thrombosis and Immune Thrombocytopenic Purpura in a Patient with a History of COVID-19 Infection
Leyla Bahadorizadeh[SUP] 1 [/SUP], Maziar Emamikhah[SUP] 2 [/SUP], Arash Pour Mohammad[SUP] 3 [/SUP], Milad Gholizadeh Mesgarha[SUP] 4 [/SUP]
Affiliations
Abstract
Since the emergence of the coronavirus disease 2019 (COVID-19) pandemic, multiple but rare complications of this infection have been described, comprising cerebral venous sinus thrombosis (CVST) and immune thrombocytopenic purpura (ITP). Although these two complications have been reported as separate entities, to the best of our knowledge, their concurrent presentation has not been reported. In this case report, we present a middle-aged man with a history of COVID-19 infection who developed a sudden-onset severe occipital headache followed by right-sided blindness (right homonymous hemianopia). Upon his diagnostic workup, brain computed tomography scan with and without contrast was indicative of thrombosis of the left transverse venous sinus and hemorrhagic venous infarction. In addition, laboratory data revealed thrombocytopenia, which upon investigation confirmed a diagnosis of ITP. We postulate three pathophysiological mechanisms for this circumstance: either COVID-19 infection caused ITP and then ITP gave rise to CVST, or COVID-19 complications themselves resulted in ITP and CVST independently and simultaneously, or another plausible mechanism is immune-mediated thrombocytopenia caused by the anti-platelet 4-factor antibody, which is the proposed mechanism for CVST after the COVID-19 vaccine.
Keywords: COVID-19; CVST; Cerebral venous sinus thrombosis; Corona virus; ITP; Immune thrombocytopenic purpura; Intracranial complication; SARS-CoV-2.
. 2021 Oct 29.
doi: 10.1007/s40120-021-00294-9. Online ahead of print.
Simultaneous Occurrence of Cerebral Venous Sinus Thrombosis and Immune Thrombocytopenic Purpura in a Patient with a History of COVID-19 Infection
Leyla Bahadorizadeh[SUP] 1 [/SUP], Maziar Emamikhah[SUP] 2 [/SUP], Arash Pour Mohammad[SUP] 3 [/SUP], Milad Gholizadeh Mesgarha[SUP] 4 [/SUP]
Affiliations
- PMID: 34714517
- DOI: 10.1007/s40120-021-00294-9
Abstract
Since the emergence of the coronavirus disease 2019 (COVID-19) pandemic, multiple but rare complications of this infection have been described, comprising cerebral venous sinus thrombosis (CVST) and immune thrombocytopenic purpura (ITP). Although these two complications have been reported as separate entities, to the best of our knowledge, their concurrent presentation has not been reported. In this case report, we present a middle-aged man with a history of COVID-19 infection who developed a sudden-onset severe occipital headache followed by right-sided blindness (right homonymous hemianopia). Upon his diagnostic workup, brain computed tomography scan with and without contrast was indicative of thrombosis of the left transverse venous sinus and hemorrhagic venous infarction. In addition, laboratory data revealed thrombocytopenia, which upon investigation confirmed a diagnosis of ITP. We postulate three pathophysiological mechanisms for this circumstance: either COVID-19 infection caused ITP and then ITP gave rise to CVST, or COVID-19 complications themselves resulted in ITP and CVST independently and simultaneously, or another plausible mechanism is immune-mediated thrombocytopenia caused by the anti-platelet 4-factor antibody, which is the proposed mechanism for CVST after the COVID-19 vaccine.
Keywords: COVID-19; CVST; Cerebral venous sinus thrombosis; Corona virus; ITP; Immune thrombocytopenic purpura; Intracranial complication; SARS-CoV-2.