TITLE:
A Rare Case Series of Cerebral Venous Thrombosis and Stroke in Young Male COVID-19 Positive Patients without Significant Comorbidities and Importance of Various Laboratory Investigations
AUTHORS:
Hardik Lalit Siroya, Bhagavatula Indira Devi, Sachin Jose Pulickal, Dhanjaya Ishwar Bhat
KEYWORDS:
Cerebral Venous Thrombosis, COVID-19, Eosinophil Count, Intracranial Haemorrhage, Stroke, Young Males
JOURNAL NAME:
Open Access Library Journal,
Vol.9 No.1,
January
26,
2022
ABSTRACT: Background: Pandemic COVID-19 has irreversibly affected all nations worldwide leading to crisis in Global healthcare of unprecedented proportions. Here we present seven cases of CVT in COVID-19 patients with three rare cases one having cerebellar CVT and the other having deep seated basal ganglia bleed, one patient with CVT with known history of ALL. We evaluated 98 cases with covid positive status presenting to our institute with neurological symptoms. All patients underwent brain and chest CT imaging. Methods: It is an observational retrospective study conducted in pre-vaccination era. All covid positive cases who were operated in NIMHANS for Cerebral venous thrombosis are included. These surgeries are typically emergency surgeries. A proper consent was taken prior to surgery. Study period—march 2020 to December 2020 before vaccination drive started in India. Place of study— National institute of mental health and neurosciences, NIMHANS, Bengaluru. Results and Interpretation: Also among the 7 cases presented 6 of them are young males. 5 did not have any prior known comorbidity. Not only the young females are being less operated, but also the young males are presenting more and most of them requiring surgical treatment. Conclusions: This neurotropism for young healthy males is far from understood. The eosinophil in peripheral blood was also extremely low in all the patients. Our data suggests that low eosinophil count though points towards severity in cerebral and pulmonary COVID-19, its non-improvement in these primary cases may suggest continued poor prognosis. Whether low eosinophil count portends to poor prognosis or severe COVID-19 leads to low eosinophil count is unclear and difficult to tell.