Anipindi Manasa, Scott Amanda, Joyce Li, Wali Salman, Morginstin Mark
Einstein Healthcare Network, Philadelphia, PA, United States.
Front Med (Lausanne). 2021 Oct 15;8:741594. doi: 10.3389/fmed.2021.741594. eCollection 2021.
Coronavirus disease-2019 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus). Coronavirus disease-2019 (COVID-19) was declared a pandemic in March 2020 and has changed our lives in many ways. This infection induces a hypercoagulable state leading to arterial and venous thrombosis, but the exact pathophysiology of thrombosis is unknown. However, various theories have been postulated including excessive cytokine release, endothelial activation, and disseminated intravascular coagulation (DIC). We present a patient diagnosed with cerebral venous sinus thrombosis (CVST) with COVID-19 infection. A 66-year-old man presented to a hospital for evaluation of persistent headaches. He tested positive for COVID-19, and MRI of the brain and CT venogram revealed CVST. He was started on heparin drip in the hospital and transitioned to oral anticoagulants at the time of discharge. His headaches improved with treatment. Even though headache is the most frequent and initial symptom of cerebral venous thrombosis, it is rarely the only symptom. A high index of suspicion is therefore required to diagnose CVST especially if the patient presents with a simple complaint like a headache. Common complaints can delay the diagnosis leading to disease progression. Considering the high mortality rates in patients diagnosed with CVST, we suggest the importance of knowing the association between COVID-19 infection and CVST, especially in susceptible patients.
2019冠状病毒病由严重急性呼吸综合征冠状病毒2（SARS-CoV-2病毒）引起。2019冠状病毒病（COVID-19）于2020年3月被宣布为大流行病，在许多方面改变了我们的生活。这种感染会引发高凝状态，导致动脉和静脉血栓形成，但血栓形成的确切病理生理学尚不清楚。然而，已经提出了各种理论，包括细胞因子过度释放、内皮激活和弥散性血管内凝血（DIC）。我们报告一例诊断为COVID-19感染合并脑静脉窦血栓形成（CVST）的患者。一名66岁男性因持续性头痛到医院就诊。他的COVID-19检测呈阳性，脑部MRI和CT静脉造影显示有CVST。他在医院开始接受肝素滴注治疗，并在出院时改用口服抗凝剂。经过治疗，他的头痛症状有所改善。尽管头痛是脑静脉血栓形成最常见的初始症状，但很少是唯一症状。因此，尤其是当患者仅表现为头痛等简单症状时，需要高度怀疑才能诊断CVST。常见症状可能会延误诊断，导致疾病进展。考虑到CVST患者的高死亡率，我们建议了解COVID-19感染与CVST之间的关联非常重要，特别是在易感患者中。
