Cerebral venous thrombosis after COVID-9 infection: case report

Abstract

Background: Cerebral venous thrombosis is a stroke that affects the veins and sinuses of the brain and could be promoted by para-meningeal and systemic infections, like COVID-19. Material and methods: case report study. Results: A 29-year-old female admitted with complaints of blurred vision, headache, general weakness, dizziness. The disease started acutely, 3 days before the hospitalization and 2 days after the discharge from infectious diseases facility due to SARS-COV-2 infection, with “blurred” vision, “thunderclap” headache with nausea, vomiting and diarrhea, generalized tonic-clonic seizure. From the past history was mentioned a medical abortion at 20 years, migraine with aura, 10 years use of oral contraceptives, COVID-19 infection confirmed 15 days before. CT-angiography of the brain revealed the partial occlusion of the transverse sinus on the right. A set of general laboratory analyses was performed to establish the procoagulant status: Protein S – 141% (70 – 130%), Protein S – 50% (57 – 53%). Thus, the patient has several risk factors that could promote a prothrombotic process: recent COVID-19 infection, history of use of oral contraceptives, S protein deficiency and migraine with aura. Conclusions: The coexistence of several risk factors in a young patient increases the risk of developing cerebral venous thrombosis. The SARSCOV-2 infection may be involved in triggering the procoagulant cascade in such patients. The most common symptom reported by patients at the onset of cerebral venous thrombosis is headache, followed by seizures and neurological deficits.