Cerebral deep venous thrombosis and COVID-19: case report

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  • 1 Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
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Herein, the authors present the case of a 54-year-old male diagnosed with coronavirus disease 2019 (COVID-19) during a screening test. The patient was asked to self-isolate at home and report with any exacerbations of symptoms. He presented later with pneumonia complicated by encephalopathy at days 14 and 15 from initial diagnosis, respectively. MRI of the brain showed bithalamic and gangliocapsular FLAIR signal abnormality with mild right-sided thalamic and periventricular diffusion restriction. A CT venogram was obtained given the distribution of edema and demonstrated deep venous thrombosis involving the bilateral internal cerebral veins and the vein of Galen. CSF workup was negative for encephalitis, as the COVID-19 polymerase chain reaction (PCR) test and bacterial cultures were negative. A complete hypercoagulable workup was negative, and the venous thrombosis was attributed to a hypercoagulable state induced by COVID-19. The mental decline was attributed to bithalamic and gangliocapsular venous infarction secondary to deep venous thrombosis. Unfortunately, the patient’s condition continued to decline, and care was withdrawn.

ABBREVIATIONS

COVID-19 = coronavirus disease 2019; CSF = cerebrospinal fluid; EVD = external ventricular drain; ICP = intracranial pressure; SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2.
Illustrations from Marx and Schroeder (pp 318–326). Copyright Henry W. S. Schroeder. Published with permission.

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Contributor Notes

Correspondence Syed Omar Shah: Thomas Jefferson University Hospital, Philadelphia, PA. syed.shah@jefferson.edu.

INCLUDE WHEN CITING Published online September 4, 2020; DOI: 10.3171/2020.5.JNS201542.

Disclosures Dr. Jabbour is a consultant for Medtronic and MicroVention. Drs. Tjoumakaris and Gooch are consultants for Stryker.

  • 1

    Bedford J , Enria D , Giesecke J , et al. COVID-19: towards controlling of a pandemic . Lancet . 2020 ;395 (10229 ):1015 1018 .

  • 2

    Akhmerov A , Marbán E . COVID-19 and the heart . Circ Res . 2020 ;126 (10 ):1443 1455 .

  • 3

    Mao L , Jin H , Wang M , et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China . JAMA Neurol . 2020 ;77 (6 ):683 690 .

    • Search Google Scholar
    • Export Citation
  • 4

    Moriguchi T , Harii N , Goto J , et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2 . Int J Infect Dis . 2020 ;94 :55 58 .

    • Search Google Scholar
    • Export Citation
  • 5

    Poyiadji N , Shahin G , Noujaim D , et al. COVID-19-associated acute hemorrhagic necrotizing encephalopathy: CT and MRI features . Radiology . 2020 ;296 (2 ):E119 E120 .

    • Search Google Scholar
    • Export Citation
  • 6

    Connors JM , Levy JH . Thromboinflammation and the hypercoagulability of COVID-19 . J Thromb Haemost . 2020 ;18 (7 ):1559 1561 .

    • Search Google Scholar
    • Export Citation
  • 7

    Zhang Y , Xiao M , Zhang S , et al. Coagulopathy and antiphospholipid antibodies in patients with Covid-19 . N Engl J Med . 2020 ;382 (17 ):e38 .

    • Search Google Scholar
    • Export Citation

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