Fulminant Extra- And Intracranial Arteriovenous Thrombosis And Non-aneurysmal Subarachnoid Hemorrhage Following COVID-19 Infection

Acta Neurol Taiwan. 2023 Jun 30:32(2):69-73.

Abstract

Purpose: Coronavirus disease of 2019 (COVID-19) is associated with increased risk of stroke and intracranial hemorrhage. This first report of fulminant panvascular arteriovenous thrombosis with subarachnoid hemorrhage (SAH) in a post-COVID-19 infection is attributed to extensive arteriovenous inflammation leading to arterial rupture following vasculitis.

Case report: We report a rare case of extensive extra- and intra-cranial cerebral arteriovenous thrombosis following COVID-19 infection, presenting as fatal non-aneurysmal subarachnoid hemorrhage. The clinical course, biochemical and radiological evaluation is discussed. The other possible etiological differentials which were analysed and ruled out during case management are also detailed.

Conclusion: A high degree of suspicion for COVID-19 induced coagulopathy leading to extensive non- aneurysmal, non-hemispheric SAH and malignant intracranial hypertension should be entertained. Our experience and previous reports on non-aneurysmal SAH in such patients show a poor prognosis.

Keywords: arterial thrombosis; basilar artery; COVID-19; non-aneurysmal SAH; superior sagittal sinus..

Publication types

  • Case Reports

MeSH terms

  • COVID-19* / complications
  • Humans
  • Intracranial Aneurysm* / complications
  • Intracranial Hypertension* / complications
  • Intracranial Thrombosis* / complications
  • Intracranial Thrombosis* / etiology
  • Stroke* / complications
  • Subarachnoid Hemorrhage* / complications
  • Subarachnoid Hemorrhage* / diagnostic imaging