Abstract
COVID-19 infection causes coagulopathy, which may lead to cerebral venous thrombotic
(CVT) event. It usually occurs in patients with higher severity level of infection
and manifests mostly within a month after the infection. However, in rare cases, the
CVT may happen long after the infection and unrelated to the degree of the infection
severity. We present the case of a previously healthy 62-year-old male patient with
very mild COVID-19 symptoms that resolved in 3 weeks of home isolation treatment.
Immediately after the infection, he developed hypercoagulability and was treated routinely
with a novel oral anti-coagulant drug. Four months after the infection, he developed
a worsening headache which, in several days, deteriorated to cause reduction in his
consciousness level. Imaging showed a right temporoparietooccipital massive brain
hemorrhage with right transverse and sigmoid sinus thrombosis. Emergency decompressive
craniectomy was performed and the patient recovery was excellent. In patients with
a hypercoagulable state after COVID-19 infection, the possibility of CVT event should
be observed. It may not be related to the severity of the infection, and it may happen
long after the infection.
Keywords
cerebral venous thrombosis - COVID-19 - long covid - decompressive craniectomy
