ABSTRACT
Pediatric stroke is considered an infrequent complication of COVID-19. Focal cerebral arteriopathy (FCA) is one of the most common causes of arterial ischemic stroke in a previously healthy child. The present report describes a toddler with FCA most likely induced by SARS-CoV-2 infection who showed significant clinical improvement that may be related to injection of intra-arterial nimodipine. To our knowledge, this is the first reported use of nimodipine in this setting.
Subject(s)
COVID-19 , Cerebral Arterial Diseases , Stroke , COVID-19/complications , Cerebral Arterial Diseases/complications , Cerebral Arterial Diseases/diagnostic imaging , Cerebral Arterial Diseases/drug therapy , Child , Child, Preschool , Humans , Nimodipine/therapeutic use , SARS-CoV-2 , Stroke/diagnostic imaging , Stroke/drug therapy , Stroke/etiologyABSTRACT
There have been limited cases linking SARS-CoV-2 infection with the development of reversible cerebral vasoconstriction syndrome (RCVS). We hereby report a rare case of RCVS in the setting of mild SARS-CoV-2 respiratory infection successfully treated with nimodipine and aspirin. SARS-CoV-2 attacks the ACE2-receptors, which are expressed in various body organs including the lungs, kidneys, and blood vessels. Vasoconstriction can result from down-regulation of the ACE2-receptors that can lead to sympathetic hypertonia of the cerebral blood vessel walls and/or over-activation of the renin-angiotensin axis.