Coagulopathy and thrombosis following COVID-19 resolution resulting in late Hyperacute ischemic stroke in moyamoya disease – A case report

Abstract

Background. Moyamoya disease (MMD) patients who untreated with bypass surgery are prone to frequent and recurrent ischemic stroke or transient ischemic attack (TIA). Although, multiple traditional risk factors can account for this event, recent COVID-19 pandemic also contributed to the increased rate of stroke recurrence among this population by means of multiple pathogenesis, including thrombosis. Case presentation. Herein we described an MMD patient who suffered from acute ischemic stroke lately after the resolution of COVID-19 infection with neurocognitive deficits as the prominent symptoms. Coagulopathy with the resulting thrombosis was thought to play a central role in this case. Conclusions. COVID-19 infection may increase the risk of stroke recurrence among patients with MMD, particularly those who do not yet undergo surgical bypass procedure. Coagulopathy with thrombosis was thought to play a central role, even after the infection itself had subsided.

Keywords

• covid-19 infection
• moyamoya disease
• coagulopathy
• thrombosis
• cognitive deficits