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

Sitanggang P.A., Tini K., Susilawathi N.M., Wijayanti I.A.S., Dewi P.U., Samatra D.P.G.P.

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


Abstract

Background: Coronavirus 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 presentation: Two 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. Conclusions: CSVT 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. © 2021, The Author(s).

Coagulation cascade; COVID 19; CSVT; Thrombogenesis


Journal

Egyptian Journal of Neurology, Psychiatry and Neurosurgery

Publisher: Springer Science and Business Media Deutschland GmbH

Volume 57, Issue 1, Art No 83, Page – , Page Count


Journal Link: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85108890992&doi=10.1186%2fs41983-021-00335-y&partnerID=40&md5=05607141a2ebbbf4eb4eb841d368714d

doi: 10.1186/s41983-021-00335-y

Issn: 11101083

Type: All Open Access, Gold, Green


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