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Cerebral Venous Sinus Thrombosis in COVID-19: An Unusual Presentation

Ikwinder Kaur1, Charmee Vyas2, Mohsin Mughal1

  • 1Internal Medicine, Monmouth Medical Center, Long Branch, USA.

Cureus
|April 12, 2021
PubMed

Insights

Cerebral venous sinus thrombosis (CVST) can occur after an undiagnosed, asymptomatic COVID-19 infection. This case shows CVST as a potential late complication, even with negative initial tests.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Vascular Medicine

Background:

  • Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is linked to increased risk of thromboembolism.
  • Cerebral venous sinus thrombosis (CVST) has been reported in patients with coronavirus disease-2019 (COVID-19).
  • Previous reports associated CVST with active COVID-19 infection or flu-like symptoms.

Observation:

  • A 41-year-old male presented with CVST.
  • The patient had negative SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test results.
  • The patient tested positive for COVID-19 immunoglobulin G (IgG) antibodies and had no prior diagnosis or flu-like illness.

Findings:

  • This case demonstrates CVST in a patient with no active COVID-19 infection or symptoms.
  • The findings suggest a possible link between prior asymptomatic SARS-CoV-2 infection and the development of CVST.
  • Immunoglobulin G (IgG) positivity indicates a past infection, not an acute one.

Implications:

  • CVST may be a delayed complication of previously unrecognized, asymptomatic COVID-19.
  • Healthcare providers should consider past asymptomatic SARS-CoV-2 infection in patients presenting with CVST, even with negative acute tests.
  • This broadens the understanding of potential neurological sequelae of COVID-19.

Keywords:
cerebral venous sinus thrombosis (cvst)corona virus disease 2019thrombo embolic disease

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