Abstract
BackgroundCoronavirus disease 2019, caused by the severe acute respiratory syndrome coronavirus 2, has a broad clinical spectrum, from asymptomatic to multi-organ dysfunction. Acute cerebrovascular events associated with coronavirus disease 2019 are mainly due to the severe acute respiratory syndrome coronavirus 2-induced prothrombotic state. Bilateral basal ganglia ischemia is rarely reported.Case presentationWe report the case of a 64-year-old Asian (Pakistani) gentleman who presented initially with fever, cough, and shortness of breath, likely due to respiratory involvement by severe acute respiratory syndrome coronavirus 2. Later, he developed bilateral lower limb pain, followed by confusion and decreased level of consciousness. Accentuated large hypodense opacities were seen in the left and right basal ganglia, with mass effects on the left frontal horn.ConclusionThis case demonstrates the importance of neuroimaging in the effective management of patients with neurological signs associated with coronavirus disease 2019.
Highlights
Coronavirus disease 2019, caused by the severe acute respiratory syndrome coronavirus 2, has a broad clinical spectrum, from asymptomatic to multi-organ dysfunction
Accentuated large hypodense opacities were seen in the left and right basal ganglia, with mass effects on the left frontal horn. This case demonstrates the importance of neuroimaging in the effective management of patients with neurological signs associated with coronavirus disease 2019
Patients with COVID-19 are at an increased risk of developing prothrombotic complications, including deep venous thrombosis, acute limb ischemia, and ischemic stroke [2]
Summary
Coronavirus disease 2019 (COVID-19) results in a broad spectrum of clinical manifestations [1]. Patients with COVID-19 are at an increased risk of developing prothrombotic complications, including deep venous thrombosis, acute limb ischemia, and ischemic stroke [2]. We present a middle-aged gentleman with COVID-19 who developed bilateral basal ganglia ischemia. Such cases highlight the atypical neurologic sequelae of COVID-19, likely secondary to the associated prothrombotic state. An urgent non-contrast computed tomography (NCCT) of the brain (Fig. 1) revealed accentuated hypodensities in the left basal ganglia (involving caudate nucleus, lentiform nucleus, and anterior limb of internal capsule), with mass effect on the ipsilateral frontal horn Another smaller hypodensity in the right caudate nucleus was seen. Autopsy was declined by the family and, could not be done
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