International Medical Case Reports Journal (Aug 2021)

Large Vessel Occlusion Causing Cerebral Ischemic Stroke in Previously Healthy Middle-Aged Recently Recovered from Severe COVID-19 Infection

  • Alhashim A,
  • Alqarni M,
  • Alabdali M,
  • Alshurem M,
  • Albakr A,
  • Hadhiah K,
  • Aljaafari D,
  • Alyami R

Journal volume & issue
Vol. Volume 14
pp. 577 – 582

Abstract

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Ali Alhashim, Mustafa Alqarni, Majed Alabdali, Mohammed Alshurem, Aishah Albakr, Kawther Hadhiah, Danah Aljaafari, Rawan Alyami Neurology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, 34212, Saudi ArabiaCorrespondence: Ali AlhashimNeurology Department, Medical College, Imam Abdulrahman Bin Faisal University, Dammam, 34212, Saudi ArabiaTel +966509444833Email [email protected]; [email protected]: Severe acute respiratory syndrome coronavirus (SARS-CoV-2) due to novel coronavirus disease 2019 (COVID-19) has led to an unprecedented worldwide pandemic with diverse respiratory symptoms as well as systemic manifestations and complications. The neurological manifestations of COVID-19 include, but are not limited to, headache, cerebrovascular disease, and skeletal muscle injury.Case Report: Herein, we present a case of stroke with large vessel occlusion in a middle-aged man, who recently recovered from severe SARS-CoV-2 infection. This patient is not known to have any medical illness or surgical history and has no cerebrovascular risk factors. Moreover, the patient underwent extensive investigations, including neuroimaging, cardiac and laboratory work-up with no evidence of stroke etiology.Conclusion: The mechanism of cerebrovascular events in the setting of COVID-19 is still uncertain and probably multi-factorial. The prevailing hypothesis is a strong thrombotic tendency, which may even be prolonged after complete recovery. In our patient’s case, hypercoagulability in the context of viral infection is the most likely mechanism for the stroke. Further studies are needed to find out the exact pathogenesis of thromboembolic events in the setting of COVID-19 infection as well as the efficacy, safety, dosage, and duration of anticoagulants in such conditions.Keywords: large vessel occlusion, stroke, healthy middle-aged, viral hypercoagulability, SARS-CoV-2, independent risk factor

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