Coronavirus disease of 2019 (COVID-19) is well known to increase the risk of developing venous thromboembolism; thus, patients with COVID-19 may present to neurologists with cerebral venous sinus thrombosis. We present a patient presenting acutely with delirium, who after initial negative viral testing, was diagnosed with cerebral venous sinus thrombosis in association with COVID-19. A 50-year-old man presented with delirium. PCR nasopharyngeal swabs for the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) were negative but we made a diagnosis of probable COVID-19 based on clinical and radiological features according to European Centre for Disease Control case definition criteria.1 Fibrinogen was 3.8 g/L (1.8–5.4) and neutrophil:lymphocyte ratio 14.4; age ≥50 years and neutrophil:lymphocyte ratio ≥3.13 have been associated with severe disease.2 D-dimer was not recorded acutely. A non-contrast CT scan of head and CSF analysis on admission were normal. We started enoxaparin 40 mg once daily subcutaneously as prophylaxis for venous thromboembolism and he did not need ventilator support. Despite clinical improvement, he had persisting problems with executive dysfunction and dyspraxia. Repeat CT scan of head and CT venogram 1 week following admission showed dural venous sinus thrombosis involving the whole of the superior sagittal sinus, left transverse sinus and left sigmoid sinus down to the level of the …

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与 COVID-19 相关的脑静脉窦血栓形成


众所周知，2019 年冠状病毒病 (COVID-19) 会增加发生静脉血栓栓塞的风险；因此，COVID-19 患者可能会因脑静脉窦血栓而就诊于神经科医生。我们介绍了一名患有急性谵妄的患者，在最初的病毒检测呈阴性后，被诊断为与 COVID-19 相关的脑静脉窦血栓形成。一名 50 岁男子出现谵妄。严重急性呼吸综合征冠状病毒 2 (SARS-COV-2) 的 PCR 鼻咽拭子结果为阴性，但我们根据欧洲疾病控制中心病例定义标准，根据临床和放射学特征，诊断出疑似 COVID-19。1 纤维蛋白原3.8 g/L (1.8–5.4)，中性粒细胞：淋巴细胞比率 14.4；年龄 ≥ 50 岁和中性粒细胞：淋巴细胞比率 ≥ 3.13 与严重疾病相关。2 D-二聚体没有急性记录。入院时头部非增强 CT 扫描和脑脊液分析均正常。我们开始每日一次皮下注射依诺肝素 40 mg，作为静脉血栓栓塞的预防，并且他不需要呼吸机支持。尽管临床有所改善，但他仍然存在执行功能障碍和运用障碍的问题。入院后 1 周重复头部 CT 扫描和 CT 静脉造影显示硬脑膜静脉窦血栓形成，累及整个上矢状窦、左横窦和左乙状窦，直至......