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[新型冠状病毒肺炎后发生的脑静脉血栓形成]

[Cerebral venous thrombosis after COVID-19].

作者信息

Tveit Lars, Enriquez Brian, Tennøe Bjørn, Warsza Bogna, Garstad Lars Jørgen, Weisshaar Martin, Aamodt Anne Hege

出版信息

Tidsskr Nor Laegeforen. 2020 Dec 14;140(18). doi: 10.4045/tidsskr.20.0563. Print 2020 Dec 15.

Abstract

BACKGROUND

There is emerging evidence of an increased risk of venous thromboembolism as well as several reports of cerebral venous thrombosis in COVID-19.

CASE PRESENTATION

A previously healthy man in his fifties was admitted due to sudden confusion and reduced consciousness. One month earlier the patient had symptoms with headache, fever, dry cough, vomiting and diarrhoea and reduced sense of taste and smell. He was diagnosed with COVID-19 and the symptoms were mainly resolved within three weeks. On admission the patient was disorientated with aphasia. Brain imaging revealed a haemorrhagic infarction in the left temporal lobe due to thrombosis of the left transverse sinus and low-molecular weight heparin was instituted. On follow-up four months later, there was clinical improvement with only slight problems with short term memory and concentration.

INTERPRETATION

This case illustrates the risk of serious neurological complications due to cerebral venous thrombosis in COVID-19.

摘要

背景

有新证据表明,新型冠状病毒肺炎(COVID-19)患者发生静脉血栓栓塞的风险增加,还有几例关于脑静脉血栓形成的报道。

病例介绍

一名50多岁以前健康的男性因突然出现意识模糊和意识减退入院。一个月前,该患者出现头痛、发热、干咳、呕吐、腹泻以及味觉和嗅觉减退等症状。他被诊断为COVID-19,症状主要在三周内得到缓解。入院时,患者定向障碍并伴有失语。脑部影像学检查显示,由于左侧横窦血栓形成,左侧颞叶出现出血性梗死,遂开始使用低分子肝素治疗。四个月后的随访结果显示,临床症状有所改善,仅短期记忆和注意力方面存在轻微问题。

解读

该病例说明了COVID-19患者因脑静脉血栓形成而出现严重神经并发症的风险。

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