Acute Multiple Cerebral Watershed Infarctions as the Initial Presentation of COVID-19 in a Young Male Patient: A Case Report

Abstract

Cerebrovascular diseases appear to be one of the most serious complications of coronavirus disease 2019 . In this report, we present a case of a 38-year-old male with a past medical history significant only for hypertension, who presented to the emergency department (ED) with confusion and multiple focal neurologic deficits. Brain imaging showed acute multiple cerebral watershed infarctions. Upon further investigation and laboratory workup, the hypercoagulability and vasculitis panels were found to be negative, and other differential diagnoses were ruled out. In light of a number of emerging reports of COVID-19related ischemic stroke, our patient was also screened for the disease, and surprisingly the test came back positive. We believe this case report will highlight the importance of conducting neurological examinations in COVID-19 patients, since timely workup and prompt interventions may reduce morbidity and mortality.

Acidente vascular encefálico isquêmico decorrente da Hipercoagulabilidade ocasionada pela Covid-19: uma revisão integrativa

“…Além disso, possuíam escore mais alto na escala de National Institute of Health Stroke Scale (NIHSS) à admissão. A ocorrência de eventos foi maior entre os homens, neste estudo.Conforme citado anteriormente, a maioria dos pacientes que desenvolveram AVEi após a infecção pela COVID-19, de acordo com os relatos de caso e demais dados dos estudos, eram jovens e do sexo masculino, como no relato de Abdelmasih et al21 de um paciente masculino de 38 anos e no de Achebe et al 20 , de 42 anos. O estudo de revisão realizado por Finsterer et al 11 também mostrou que a incidência de AVEi em pacientes infectados pela COVID-19 é maior em homens, visto que 43 dos 59 pacientes analisados que apresentavam esta condição, eram do sexo masculino.…”