Large Cerebellar Stroke in a Young COVID-19-Positive Patient: Case Report

Area of Science:

• Neurology
• Infectious Diseases
• Vascular Medicine

Background:

• Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, typically presents with respiratory symptoms.
• Emerging evidence links severe SARS-CoV-2 infections to coagulopathy, inflammation, and cardiomyopathy.
• These complications are implicated in COVID-19-associated cerebrovascular accidents (CVAs).

Observation:

• A 32-year-old male presented with a large vessel cerebellar stroke and severe COVID-19.
• Initial symptoms included headache, dizziness, nystagmus, and dysmetria, without respiratory compromise.
• The patient was ineligible for thrombolytic or endovascular therapy, receiving antiplatelet and statin treatment.

Findings:

• The patient developed COVID-19-related hypoxia and pneumonia during hospitalization.
• Despite the stroke severity, he was discharged for home rehabilitation.
• This case underscores the potential for severe neurologic complications in COVID-19 patients.

Implications:

• Emergency physicians must be aware of the increasing reports of neurologic and vascular complications, including ischemic CVAs, in SARS-CoV-2 infected individuals.
• Understanding the mechanisms, risk factors, and treatments for COVID-19-associated CVAs is crucial.
• This case emphasizes the need for vigilance regarding cerebrovascular events in patients with COVID-19, even in the absence of typical respiratory symptoms.