Some of the first CT angiography images documenting the rapid progression of acute ischemic stroke in a patient with COVID-19 were published on May 14 in the American Journal of Neuroradiology (AJNR).
More and more evidence is emerging about the link between COVID-19 and the risk of stroke, particularly among individuals under the age of 50. A definitive cause is still unknown, but patients with severe cases of COVID-19 appear to be at a greater risk for blood clots.
A reason why this may be the case could be that the SARS-CoV-2 virus directly targets the endothelial cells that line blood vessels, which may also put a patient at risk for stroke, according to a study published earlier this month in the Lancet (May 2, 2020, Vol. 395:10234, pp. 1417-1418).
The current case study from Allegheny Health Network Stroke Center in Pittsburgh is of a 64-year-old man who presented to the emergency department after waking up at home with symptoms of left-sided paralysis and shortness of breath. He had tested positive for COVID-19 16 days prior and was recovering well before his sudden onset of ischemic stroke. The patient passed away from complications of COVID-19 three days after admission to the hospital.
Data about COVID-19 gathered around the world suggests 5% to 6% of patients with severe cases may suffer a cerebrovascular injury.
"What's unique with our case is that the patient represented a subgroup where a stroke may occur in someone with atypical symptomatic onset," said Dr. Michael Goldberg, a neuroradiologist and director of the Allegheny Health Network Division of Neuroradiology.
The researchers plan to focus their efforts to better treat cerebrovascular injury, they said.