Post-infectious cerebellar ataxia following COVID-19 in a patient with epilepsy.

Background: Various neurological manifestations have been described in relation to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19). However, the development of cerebellar ataxia after recovery from COVID-19 is rare. We present a case of cerebellar ataxia 3 weeks after recovery from COVID-19. Case Presentation: A 70-year-old male patient from an urban area of India presented with ataxia. He was hypertensive and had been receiving treatment for post-traumatic epilepsy for the previous 3 years. He had previously had laboratory-confirmed COVID-19 infection with mild symptoms that resolved within 2 weeks. However, 3 weeks after symptom improvement, he developed severe pan-cerebellar ataxia. Investigations were suggestive of post-infectious cerebellar ataxia. Other causes of ataxia were excluded. He responded well to pulse methylprednisolone therapy and was discharged with mild tremor and ataxia. Conclusion: Post-infectious cerebellar ataxia is an unusual presentation after COVID-19. The clinician should be aware of such complications following COVID-19 infection as early diagnosis and proper management leads to better outcomes in many patients.

Successful Endovascular Treatment of Cerebral Venous Thrombosis with a Novel, Larger Aspiration Catheter (REACT): A Case Report.

Cerebral venous thrombosis (CVT) is a rare clinical entity, with clinical presentations extending from headache and seizures to coma and death. For adults developing progressive neurological worsening despite adequate medical management, endovascular thrombolysis and/or mechanical thrombectomy may be considered as treatment options. We present one such patient with CVT who developed seizures and slipped into a coma, despite best medical management. A large-bore aspiration catheter was used as a standalone system for the endovascular procedure. The venous sinuses were successfully re-canalized. The patient was discharged a week later with a modified Rankin scale of 2. Studies show that endovascular thrombolysis used alone or in conjunction with thrombectomy for CVT has a higher risk of hemorrhagic complications. If we were to use mechanical thrombectomy devices (that are specifically designed for intracranial clot retrieval) as a stand-alone system, we would probably have better clinical outcomes with a lower risk of hemorrhagic complications.