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Acute Multiple Cerebral Watershed Infarctions as the Initial Presentation of COVID-19 in a Young Male Patient: A Case
Randa Abdelmasih1, Ramy Abdelmaseih1, Radhames Ramos De Oleo1
1Internal Medicine, University of Central Florida College of Medicine, Ocala, USA.
Insights
A young man with hypertension developed stroke symptoms and was diagnosed with coronavirus disease 2019 (COVID-19). This case highlights the need for neurological assessments in COVID-19 patients to improve outcomes.
Area of Science:
- Neurology
- Infectious Diseases
- Vascular Medicine
Background:
- Cerebrovascular diseases are a severe complication of COVID-19.
- Emerging reports link COVID-19 to ischemic stroke.
Abstract:
Cerebrovascular diseases appear to be one of the most serious complications of coronavirus disease 2019 (COVID-19). In this report, we present a case of a 38-year-old male with a past medical history significant only for hypertension, who presented to the emergency department (ED) with confusion and multiple focal neurologic deficits. Brain imaging showed acute multiple cerebral watershed infarctions. Upon further investigation and laboratory workup, the hypercoagulability and vasculitis panels were found to be negative, and other differential diagnoses were ruled out. In light of a number of emerging reports of COVID-19-related ischemic stroke, our patient was also screened for the disease, and surprisingly the test came back positive. We believe this case report will highlight the importance of conducting neurological examinations in COVID-19 patients, since timely workup and prompt interventions may reduce morbidity and mortality.
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