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COVID-19 Cerebral Vasculitis With Extensive Involvement of Anterior Circulation and Sparing of Posterior Circulation

Thomas E Kent1, Sohil H Patel2, Prem P Batchala2

  • 1School of Medicine, University of Florida, Gainesville, USA.

Cureus
|July 28, 2025
PubMed

Insights

COVID-19 infection can cause stroke through mechanisms like vasculitis and thrombosis. This case highlights anterior circulation vasculitis and ischemic stroke in a COVID-19 patient, sparing the posterior circulation.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • COVID-19 infection is linked to cerebrovascular events, including ischemic stroke.
  • Proposed mechanisms involve inflammation, vasculitis, and thrombosis affecting cerebral vessels.

Observation:

  • A patient presented with symptoms suggestive of central nervous system (CNS) involvement following COVID-19 infection.
  • Vessel wall imaging was utilized to investigate the cause of stroke.

Findings:

  • The patient exhibited extensive anterior circulation vasculitis and suffered an ischemic stroke.
  • Notably, the posterior circulation remained unaffected, suggesting a localized inflammatory process.

Implications:

  • Vessel wall imaging aids in diagnosing COVID-19-associated stroke and differentiating its etiology.
  • Understanding these mechanisms is crucial for managing neurological complications of COVID-19.

Keywords:
acute ischemic strokecovid-19posterior circulationvasculitisvessel wall imaging

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