Cardoso Erico Ramos, Bains Sandeep Singh, Robison Benjamin, Farkas Jeffrey
Department of Surgery, Richmond University Medical Center, New York City, NY, USA.
Department of Radiology, Richmond University Medical Center, New York City, NY, USA.
Am J Case Rep. 2021 Jan 1;22:e927011. doi: 10.12659/AJCR.927011.
BACKGROUND Pandemic coronavirus disease 2019 (COVID-19) originated in Wuhan, China, and is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Severe respiratory symptoms are a hallmark of the disease, which may also include complications related to a hypercoagulable state and central nervous system involvement. These complications can occur during either the acute or the recovery phase. The cerebral involvement typically manifests as intracranial hypertension, intracerebral hemorrhage, diffuse encephalopathy, or cerebral venous thrombosis. The hemorrhagic form of cerebral venous thrombosis can be a diagnostic challenge and is treated by anticoagulation therapy, despite the existence of an intracerebral hemorrhage. This report describes a case of superficial cerebral venous thrombosis and intracerebral hematoma in a 48-year-old man weeks after recovering from the acute phase of SARSCoV-2 infection. CASE REPORT A 48-year-old man with a past medical history of SARS-CoV-2 infection confirmed by SARS-CoV-2 reverse-transcription polymerase chain reaction presented with left upper-limb numbness, weakness, and impaired positional sensorium. After initial stabilization, noncontrast computerized tomography and magnetic resonance imaging confirmed an intracerebral hemorrhage with underlying cerebral venous thrombosis. The patient was successfully treated with enoxaparin anticoagulation therapy, and symptoms improved over the following 12 days. CONCLUSIONS Central nervous system venous thrombosis is an atypical presentation of the hypercoagulable state primarily seen in younger patients, and it can occur in a delayed fashion after recovery from mild forms of COVID-19.
背景 2019 年冠状病毒病大流行（COVID-19）起源于中国武汉，由严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起。严重的呼吸道症状是该疾病的一个标志，其还可能包括与高凝状态和中枢神经系统受累相关的并发症。这些并发症可发生在急性期或恢复期。脑部受累通常表现为颅内高压、脑出血、弥漫性脑病或脑静脉血栓形成。脑静脉血栓形成的出血形式可能是一个诊断难题，尽管存在脑出血，但仍通过抗凝治疗。本报告描述了一名 48 岁男性在从 SARS-CoV-2 感染急性期康复数周后发生浅表性脑静脉血栓形成和脑内血肿的病例。病例报告 一名有 SARS-CoV-2 逆转录聚合酶链反应确诊的 SARS-CoV-2 感染病史的 48 岁男性，出现左上肢麻木、无力和位置感觉受损。在初步稳定后，非增强计算机断层扫描和磁共振成像证实为伴有潜在脑静脉血栓形成的脑出血。该患者接受依诺肝素抗凝治疗成功，症状在接下来的 12 天内有所改善。结论 中枢神经系统静脉血栓形成是高凝状态的一种非典型表现，主要见于年轻患者，并且可在从轻度 COVID-19 康复后延迟发生。
