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Cerebral venous sinus thrombosis associated with COVID-19: a case series and literature review.
Ostovan, Vahid Reza; Foroughi, Razieh; Rostami, Mahtab; Almasi-Dooghaee, Mostafa; Esmaili, Manouchehr; Bidaki, Ali Akbar; Behzadi, Zahra; Farzadfard, Farzane; Marbooti, Hoda; Rahimi-Jaberi, Abbas; Poursadeghfard, Maryam; Fadakar, Nima; Bayat, Mahnaz; Owjfard, Maryam; Salehi, Mohammad Saied; Zafarmand, Seyedeh Shaghayegh; Mardi, Farzad; Safari, Anahid; Shahjouei, Shima; Mowla, Ashkan; Azarpazhooh, Mahmoud Reza; Zand, Ramin; Hooshmandi, Etrat; Borhani-Haghighi, Afshin.
  • Ostovan VR; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
  • Foroughi R; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
  • Rostami M; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
  • Almasi-Dooghaee M; Neurology Department, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
  • Esmaili M; Neurology Department, Naghadeh Hospital, Urmia University of Medical Sciences, Urmia, Iran.
  • Bidaki AA; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
  • Behzadi Z; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
  • Farzadfard F; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
  • Marbooti H; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
  • Rahimi-Jaberi A; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
  • Poursadeghfard M; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
  • Fadakar N; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
  • Bayat M; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
  • Owjfard M; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
  • Salehi MS; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
  • Zafarmand SS; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
  • Mardi F; Neurology Department, Naghadeh Hospital, Urmia University of Medical Sciences, Urmia, Iran.
  • Safari A; Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Shahjouei S; Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA.
  • Mowla A; Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
  • Azarpazhooh MR; Department of Clinical Neurological Sciences and Stroke Prevention and Atherosclerosis Research Center, Western University, London, Canada.
  • Zand R; Neuroscience Institute, Geisinger Health System, Danville, PA, USA.
  • Hooshmandi E; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran. ehoshmandi@gmail.com.
  • Borhani-Haghighi A; Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran. neuro.ab@gmail.com.
J Neurol ; 268(10): 3549-3560, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1092677
ABSTRACT

BACKGROUND:

Since the emergence of COVID-19 pandemic, several cases of cerebral venous sinus thrombosis (CVST) have been reported in SARS-CoV-2 infected individuals.

METHODS:

Consecutive patients with documented SARS-CoV-2 infection, as well as clinical and radiological characteristics of CVST, were reported from three teaching hospitals in the South West, North West, and the center of Iran between June and July 2020. We also searched the abstract archives until the end of August 2020 and gathered 28 reported cases. The diagnostic criteria for SARS-CoV-2 infection were determined according to SARS-CoV-2 detection in oropharyngeal or nasopharyngeal samples in clinically suspected patients. Demographics, prominent COVID-19 symptoms, confirmatory tests for SARS-CoV-2 infection diagnosis, the interval between the diagnosis of SARS-CoV-2 infection and CVST, clinical and radiological features of CVST, therapeutic strategies, CVST outcomes, rate of hemorrhagic transformation, and mortality rate were investigated.

RESULTS:

Six patients (31-62 years-old) with confirmed CVST and SARS-CoV-2 infection were admitted to our centers. Four patients had no respiratory symptoms of SARS-CoV-2 infection. Five patients developed the clinical manifestations of CVST and SARS-CoV-2 infection simultaneously. Three patients had known predisposing factors for CVST. Despite receiving CVST and SARS-CoV-2 infection treatments, four patients died. SARS-COV-2 associated CVST patients were older (49.26 vs. 37.77 years-old), had lower female/male ratio (1.42 vs. 2.19), and higher mortality rate (35.29% vs. 6.07%) than CVST not associated with COVID-19.

CONCLUSIONS:

The role of SARS-CoV-2 as a "cause" versus an "additive contributor" remains to be elucidated. Practitioners should be aware of the possibility of CVST in SARS-CoV-2 infection.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Sinus Thrombosis, Intracranial / COVID-19 Type of study: Reviews / Risk factors Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: J Neurol Year: 2021 Document Type: Article Affiliation country: S00415-021-10450-8

Full text: Available Collection: International databases Database: MEDLINE Main subject: Sinus Thrombosis, Intracranial / COVID-19 Type of study: Reviews / Risk factors Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: J Neurol Year: 2021 Document Type: Article Affiliation country: S00415-021-10450-8