Abouhashem Safwat, Eldawoody Hany, Taha Mahmoud M
Department of Neurosurgery, Faculty of Medicine, Zagazig University, Egypt.
Department of Neurosurgery, Saudi German Hospital, Riyadh, Saudi Arabia.
Interdiscip Neurosurg. 2021 Jun;24:101091. doi: 10.1016/j.inat.2021.101091. Epub 2021 Jan 7.
Despite the COVID-19 infection is more frequently related to acute respiratory distress but there is an increasing evidence of a heterogeneous spectrum of multi-system involvement including the central nervous system. Thromboembolic events after COVID-19 infection have been reported mainly in the pulmonary vasculature however; thromboembolic complications of the nervous system with subsequent cerebrovascular stroke have been increasingly reported. The most common cerebrovascular complication after COVID-19 infection is ischemic stroke however there is also reported cases of cerebral venous sinus thrombosis in such patients as well. In the current report we present two cases with extensive cerebral venous sinus thrombosis as a potential complication for COVID-19 infection.
Increase the awareness of neurological complications in patient with COVID-19 virus disease.
Reporting two cases with confirmed cerebral venous sinus obstruction in patient with confirmed COVID-19 infection.
Two young adult males less than 30 years old have no other risk factors of hypercoagulable state apart from being COVID-19 infection victims complicated by CVST. Both of them had progressive course of deterioration in conscious level, right hemiplegia and only one seizures attack has been reported in (Case-1). Both patients in the current report died within one week of their initial symptoms in spite the aggressive medical and surgical treatment.
CVST is a devastating complication when associated with COVID-19 infection and early investigations for cerebrovascular integrity by using MRA, MRV whenever there are unexplained neurological manifestations in patient with COVID-19 disease.
尽管新冠病毒感染更常与急性呼吸窘迫相关，但越来越多的证据表明其存在多系统受累的异质性谱，包括中枢神经系统。然而，新冠病毒感染后的血栓栓塞事件主要报道于肺血管系统；神经系统的血栓栓塞并发症及随后的脑血管卒中报道日益增多。新冠病毒感染后最常见的脑血管并发症是缺血性卒中，不过也有此类患者发生脑静脉窦血栓形成的病例报道。在本报告中，我们呈现两例广泛脑静脉窦血栓形成病例，其为新冠病毒感染的潜在并发症。
提高对新冠病毒疾病患者神经并发症的认识。
报告两例确诊新冠病毒感染且确诊脑静脉窦阻塞的病例。
两名年龄小于30岁的年轻成年男性，除了是新冠病毒感染受害者并并发脑静脉窦血栓形成外，无其他高凝状态危险因素。他们均有意识水平进行性恶化、右侧偏瘫的病程，且仅（病例1）报告有一次癫痫发作。尽管进行了积极的内科和外科治疗，本报告中的两名患者均在出现初始症状后一周内死亡。
脑静脉窦血栓形成与新冠病毒感染相关时是一种毁灭性并发症，对于新冠病毒疾病患者，一旦出现无法解释的神经表现，应尽早使用磁共振血管造影（MRA）、磁共振静脉血管造影（MRV）对脑血管完整性进行检查。
