Cerebral venous sinus thrombosis associated with oligosymptomatic COVID-19 infection: A case report

Abstract

Introduction. Severe acute respiratory syndrome coronavirus 2 infection-induced coagulopathy may cause various thrombotic complications, such as cerebral venous sinus thrombosis, a less common type of stroke with a variable clinical presentation and high mortality rate. The objective of this paper was to identify clinical, laboratory and radiological characteristics, risk factors, therapeutic modalities, and outcome of a young patient with cerebral venous sinus thrombosis associated with oligosymptomatic coronavirus disease 2019 infection. Case Report. We present a case of a 32-year-old woman suffering from a stroke due to cerebral venous sinus thrombosis associated with a mild form of coronavirus disease 2019 infection. The patient was without a history of previous diseases and risk factors for cerebral venous sinus thrombosis. Two weeks before the cerebrovascular incident, the patient presented with oligosymptomatic coronavirus disease 2019 infection associated with headache. Laboratory findings were characterized by two conditions: hypercoagulability and systemic inflammation. Bilateral thalamic and right frontal hemorrhagic venous infarctions with superior sagittal and straight sinus thrombosis and thrombosis of the vein of Galen were established by magnetic resonance imaging of the head. The main therapeutic approaches included anticoagulant therapy, therapeutic protocol for coronavirus disease 2019 infection, seizure control therapy and intracranial hypertension management. The treatment outcome was good, with minimal residual symptoms. Conclusion. Physicians should always consider the high risk of cerebral venous sinus thrombosis with nonspecific neurological symptoms in patients with mild coronavirus disease 2019 infection in order to provide early diagnosis, the most effective individually tailored treatment, and to prevent complications.