Reversible cerebral vasoconstriction syndrome and dissection in the setting of COVID-19 infection

J Stroke Cerebrovasc Dis. 2020 Sep;29(9):105011. doi: 10.1016/j.jstrokecerebrovasdis.2020.105011. Epub 2020 Jun 5.

Abstract

The current COVID-19 pandemic has recently brought to attention the myriad of neuro- logic sequelae associated with Coronavirus infection including the predilection for stroke, particularly in young patients. Reversible cerebral vasoconstriction syndrome (RCVS) is a well-described clinical syndrome leading to vasoconstriction in the intracra- nial vessels, and has been associated with convexity subarachnoid hemorrhage and oc- casionally cervical artery dissection. It is usually reported in the context of a trigger such as medications, recreational drugs, or the postpartum state; however, it has not been described in COVID-19 infection. We report a case of both cervical vertebral ar- tery dissection as well as convexity subarachnoid hemorrhage due to RCVS, in a pa- tient with COVID-19 infection and no other triggers.

Keywords: COVID-19; Convexity subarachnoid hemorrhage; Coronavirus,; Reversible cerebral vasoconstriction syndrome; Vertebral artery dissection.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Betacoronavirus / pathogenicity*
  • COVID-19
  • Cerebral Arteries / diagnostic imaging
  • Cerebral Arteries / drug effects
  • Cerebral Arteries / physiopathology*
  • Coronavirus Infections / complications*
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / virology
  • Female
  • Headache Disorders, Primary / etiology
  • Headache Disorders, Primary / physiopathology
  • Host-Pathogen Interactions
  • Humans
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / virology
  • Risk Factors
  • SARS-CoV-2
  • Subarachnoid Hemorrhage / complications*
  • Subarachnoid Hemorrhage / diagnostic imaging
  • Subarachnoid Hemorrhage / drug therapy
  • Subarachnoid Hemorrhage / physiopathology
  • Syndrome
  • Vasoconstriction* / drug effects
  • Vasodilation
  • Vertebral Artery Dissection / complications*
  • Vertebral Artery Dissection / diagnostic imaging
  • Vertebral Artery Dissection / drug therapy
  • Vertebral Artery Dissection / physiopathology