Multiple cerebral infarction coexisted with peripheral arterial occlusion after COVID-19 infection: a case review

Hur, Yang Rok; Song, Woo Sup; Kim, Kyung Min; Hwang, Ki Hun; Han, Dong Cheol

J Korean Soc Emerg Med > Volume 34(2); 2023 > Article

Case Report

Journal of The Korean Society of Emergency Medicine 2023;34(2): 184-188.

Multiple cerebral infarction coexisted with peripheral arterial occlusion after COVID-19 infection: a case review

¹Department of Physical Medicine and Rehabilitation, Dong-Eui Hospital, Busan, Korea
²Department of Physical Neurology, Dong-Eui Hospital, Busan, Korea

Correspondence

Yang Rok Hur ,Tel: 051-850-8508, Fax: 051-867-5162, Email: roko1919@naver.com,

Received: April 21, 2022; Revised: June 7, 2022 Accepted: July 24, 2022. Published online: April 30, 2023.

ABSTRACT

Multiple cerebral infarctions coexisting with peripheral artery occlusion have been rarely reported and occur only in specific conditions. Also, the characteristics of thrombosis related to the outbreak of the coronavirus disease 2019 (COVID-19) have been observed and studied recently. We report a case of concurrent multiple cerebral infarctions and peripheral embolism in a patient with a recent history of COVID-19 infection. A 62-year-old male patient who had recently been infected with COVID-19 presented to our emergency department with left hemiparesis. Supportive treatments were given post the diagnosis of multiple cerebral infarctions in the right cerebral hemisphere. During the supportive treatments, motor weakness was seen in the right upper extremity. Computed tomography revealed thrombi in the right axillary, brachiocephalic, and brachial arteries. The patient was already taking antiplatelet and anticoagulant agents and had no other underlying disease to develop such occlusions except his recent history of COVID-19 infection. We checked his laboratory tests for coagulation profiles throughout the hospitalization to verify a possible cause. We believe that large thrombi formation due to COVID-19 can simultaneously cause embolism in the cerebrum and peripheral regions. This pathology can result in symptoms that could make diagnosis difficult, delaying treatment decisions. This report, therefore, suggests that it is necessary to take into account a patient’s history of COVID-19 infection in such situations, especially when the patient presents with symptoms of a stroke.

Key words: Ischemic stroke, COVID-19, Thrombosis, Embolism