2023 Volume 45 Issue 5 Pages 407-413
A healthy 27-year-old man was admitted to our hospital because of fever and a generalized convulsion. He was diagnosed with moderate I COVID-19 by rapid antigen testing, followed by mild pneumonia in the peripheral area of both lungs on chest computed tomography. Although his symptoms worsened to moderate II severity after admission, they were alleviated by dexamethasone. He was subsequently discharged from the hospital. However, two days following discharge, i.e., 20 days after the disease onset, he was rushed to the emergency room for mild left hemiparesis. He was rehospitalized with a diagnosis of infarction in the right middle cerebral artery territory and thrombosis of the left sigmoid sinus. Other than a slightly elevated D-dimer level of 1.32 µg/ml (<1.0 µg/ml), no other coagulation system abnormalities or risk factors for thrombosis were evident. Based on the longitudinal changes on brain magnetic resonance imaging after admission, the infarction was attributed to arterial dissection. The patient was treated conservatively with anticoagulation and antihypertensive management because the infarction was completed before the readmission. Following the treatment, he was discharged without neurological deficits. To the best of our knowledge, this is the first report of a case of COVID-19 that presented simultaneously with concomitant cerebrovascular disorders having different mechanisms, arterial dissection, and sinus thrombosis.
