Cerebral Venous Sinus Thrombosis in Patients With SARS-CoV-2

Abstract

Several neurological manifestations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported, including cerebral venous sinus thrombosis (CVST). In this report, we discuss two cases of cerebral venous thrombosis in young patients with a recent SARS-CoV-2 infection and otherwise unrevealing workup. Case 1 was a 35-year-old man who was found unresponsive with urinary incontinence and vomitus on the floor. Computed tomography (CT) angiogram of the head revealed evidence of extensive venous thrombosis. Extensive workup for thrombotic disease was unrevealing and SARS-CoV-2 was detected via polymerase chain reaction. Anticoagulation was immediately initiated, and the patient made a good clinical recovery. Case 2 was a 31-year-old man who presented with severe decreased level of consciousness and was found to have extensive cerebral sinus thrombosis. Past medical history was significant for a recent SARS-CoV-2 infection diagnosed 12 days prior. The patient was treated with intravenous heparin and eventually oral anticoagulation with good clinical outcome. CVST is a potential cerebrovascular complication of SARS-CoV-2. We advise clinicians to consider this diagnosis in patients with a recent SARS-CoV-2 infection in the appropriate clinical setting.