Cerebral Venous Sinus Thrombosis in COVID-19 Infection: A Case Series and Review of The Literature
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.
Dakay, K., Cooper, J., Bloomfield, J., Overby, P., Mayer, S. A., Nuoman, R., Sahni, R., Gulko, E., Kaur, G., Santarelli, J., Gandhi, C. D., & Al-Mufti, F. (2021). Cerebral Venous Sinus Thrombosis in COVID-19 Infection: A Case Series and Review of The Literature. Journal of Stroke & Cerebrovascular Diseases, 30 (1), 105434-105434. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105434