The Acute Ischemic Stroke Induced by Covid-19 Disease - A Case Report

Abstract

Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which is the agent of Coronavirus disease 2019 (COVID-19), may attack the central nervous system in addition to the respiratory system because of its neuro-invasive features. Increased inflammation, immobilization, hypoxia, and disseminated intravascular coagulation may predispose to cerebrovascular diseases.
Case Report: A 73 years old man presenting to the emergency service with complaints of dyspnea, cough, and high fever was admitted to the hospital after being diagnosed as having COVID-19 upon findings of ground-glass densities and mild parenchymal involvement which was more prominent in the mid-and lower lobes of the lungs on his computerized tomography scan. His treatment was started with chloroquine, azithromycin, ceftriaxone, and enoxaparin. On the neurological exam performed for symptoms of dizziness, imbalance, speech disorder, and deviation of angle of mouth; he was conscious, cooperating, oriented limitedly and the right nasolabial groove was indistinct and he had dysarthria and ataxia. Acetylsalicylic acid was added to the treatment because cerebral diffusion magnetic resonance imaging revealed limited diffusion consistent with acute ischemia on the right posterolateral area of the bulbous. The patient whose respiratory distress worsened and who was admitted to the intensive care unit developed cardiac and respiratory arrest and he died despite all efforts of resuscitation.
Conclusion: It should be kept in mind that the elderly patients with Covid-19 with prothrombotic risk factors are also at risk for cerebrovascular disease in addition to the infectious symptoms. In this case report, a patient infected with SARS-CoV-2 and diagnosed with acute ischemic stroke with anamnesis, clinical and radiological findings is presented.