Cerebral Venous Thrombosis in a patient with COVID-19

Abstract

Introduction: Cerebral venous sinus thrombosis is a rare disease that affects the venous drainage of the brain; Among the risk factors we can find the SARS-CoV-2 infection that causes severe acute respiratory syndrome, which creates a state of systemic hypercoagulopathy.

Objective: To describe clinical and imaging aspects of post-COVID dural venous sinus thrombosis in a patient with no other demonstrable etiology.

Case presentation: A 54-year-old female patient, right-handed, with a personal pathological history of having presented SARS-Cov 2 infection one month before the onset of neurological symptoms. She began with a slow and progressive right hemicrania headache of moderate intensity that did not subside with oral analgesics; Two days later, the patient began with left hemiparesis and thermal and painful hypoesthesia and seizures. A CT of the skull is performed where direct signs of cerebral venous thrombosis are observed, such as the chord sign, and MRI showing venous infarction and engorgement of the venous system. Low molecular weight heparin treatment is started immediately. The patient presented satisfactory evolution.

Conclusions: The case presented is an example of a patient with cerebral venous sinus thrombosis associated with Covid-19 infection, with a typical clinical-imaging picture, with improvement favored by the treatment used.