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[A case of cerebral embolism with Coronavirus disease 2019]

Ken-Ichi Shibata1, Tatsuya Mukai1, Hideaki Nakagaki1

  • 1Department of Neurology, Fukuoka City Hospital.

Rinsho Shinkeigaku = Clinical Neurology
|June 21, 2021
PubMed

Insights

A man with persistent fever developed acute ischemic stroke, presenting as left arm palsy. His stroke was potentially linked to blood clotting issues caused by SARS-CoV-2 infection.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Persistent fever can precede serious neurological events.
  • Acute ischemic stroke requires prompt diagnosis and investigation of underlying causes.
  • Coronavirus disease 2019 (COVID-19) has been associated with various neurological complications.

Observation:

  • A 63-year-old male presented with a month of fever, followed by acute left arm palsy (NIHSS 3).
  • Brain MRI revealed ischemic changes in bilateral occipital, right parietal, and right frontal lobes (DWI) and left occipital lobe (FLAIR).
  • MRA showed reduced blood flow in the middle cerebral artery, confirming acute ischemic stroke. Chest CT indicated ground-glass opacities, and SARS-CoV-2 testing was positive.

Findings:

  • The patient was diagnosed with acute ischemic stroke.
  • Cerebral embolism was suspected, but the embolic source remained unidentified.
  • The ischemic stroke was potentially associated with COVID-19-induced coagulation abnormalities.

Implications:

  • This case highlights a potential link between COVID-19 and ischemic stroke, possibly due to altered coagulation.
  • Further research is needed to understand the mechanisms of COVID-19-related stroke.
  • Early recognition of neurological symptoms in febrile patients with positive SARS-CoV-2 tests is crucial.
Keywords:
COVID-19SARS-CoV-2cerebral embolismischemic stroke

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