Related Experiment Video
Updated: Oct 9, 2025
Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
Hypercoagulable State Induced Spinal Cord Stroke After Coronavirus Disease 19 Infection
1Department of Neurology, Faculty Medicine, Universitas Padjadjaran/RSUP Dr. Hasan Sadikin Bandung, Bandung, Indonesia.
Insights
Spinal cord stroke is a rare complication of coronavirus disease 2019 (COVID-19). This case report highlights COVID-19-induced coagulopathy leading to spinal artery occlusion and stroke, with partial recovery after anticoagulant therapy.
Area of Science:
- Neurology
- Infectious Diseases
- Vascular Medicine
Background:
- Spinal cord stroke is an uncommon but serious complication following coronavirus disease 2019 (COVID-19) infection.
- COVID-19 is associated with a hypercoagulable state, increasing the risk of thromboembolic events, including spinal artery occlusion.
Observation:
- A 60-year-old male with confirmed COVID-19 presented with acute flaccid paraplegia, sensory loss, and autonomic dysfunction 14 days post-infection.
- Clinical presentation included elevated D-dimer and fibrinogen levels, consistent with a hypercoagulable state.
- Magnetic resonance imaging revealed spinal artery stenosis at the T12 level, indicative of ischemia.
Findings:
- The patient experienced spinal cord ischemia attributed to COVID-19-related coagulopathy and spinal artery occlusion.
- Treatment with subcutaneous anticoagulation led to partial recovery of motor function, sensory symptoms, and autonomic function.
Implications:
- Coronavirus disease 2019 can precipitate endothelial damage and activate thrombotic pathways, potentially causing spinal cord stroke.
- This case underscores the importance of considering thromboembolic complications in patients with neurological deficits following COVID-19.
- Early diagnosis and anticoagulant therapy may improve outcomes in COVID-19-associated spinal cord ischemia.
Background:
Spinal cord stroke after coronavirus disease 19 (COVID-19) infection is rare, and limited cases have been reported. Spinal cord ischemia after COVID-19 infection is related to increased coagulopathy with thromboembolic consequences. Patients with COVID-19 may have a hypercoagulable state and an increased rate of thromboembolic events, such as occlusion in the spinal artery.
Case Presentation:
We report a male case with confirmed COVID-19 infection, aged 60 years, with flaccid paraplegia, hyporeflexia, loss of sensation below the 12th thoracic level, loss of autonomic function, bilateral positive Babinski sign 14 days after the onset of flu-like symptoms, and elevated serum D-dimer and fibrinogen levels. There was stenosis of the spinal artery at the 12th thoracic level in magnetic resonance imaging and magnetic resonance angiography. He showed improvement in motor strength of the lower limb (walking with assistance), numbness and pain, and urine and fecal retention after receiving a subcutaneous anticoagulant.
Conclusion:
COVID-19 can damage endothelial cells and activate thrombotic pathways, which can lead to clinical thromboembolic complications, such as occlusion in the spinal artery, resulting in spinal cord stroke.
Related Concept Videos
01:27Regulation of Stroke Volume
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
01:26Spinal Cord