Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Cerebral venous sinus thrombosis presenting transient ischemic attack after recovery from COVID-19 with Graves' disease and IgG4-related ophthalmic disease: a case report

Shuhei Egashira, M.D.1)2), Takeshi Yoshimoto, M.D., Ph.D.2), Kanta Tanaka, M.D., Ph.D.1)3), Naruhiko Kamogawa, M.D.1), Masayuki Shiozawa, M.D.1), Junpei Koge, M.D.1), Kazunori Toyoda, M.D., Ph.D.1) and Masatoshi Koga, M.D., Ph.D.1)

1) Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center
2) Department of Neurology, National Cerebral and Cardiovascular Center
3) Division of Stroke Care Unit, National Cerebral and Cardiovascular Center

A 57-year-old man presented with headache, transient right upper extremity weakness and numbness one month after recovery from coronavirus disease 2019 (COVID-19). His medical history included Graves' disease and IgG4-related ophthalmic disease. He had been administered prednisolone. His weakness and numbness were transient and not present on admission. Contrast-enhanced CT and MRI of the head showed thrombi in the superior sagittal sinus, right transverse sinus, sigmoid sinus, and the right internal jugular vein. Digital subtraction angiography showed occlusion at the same sites and mild perfusion delay in the left frontoparietal lobe. We diagnosed the patient with cerebral venous sinus thrombosis and treated him with anticoagulation. The thrombi partially regressed three months later, and perfusion delay became less noticeable. Cerebral venous sinus thrombosis is an important complication of COVID-19. Patients with predisposing factors, including Graves' disease and IgG4-related ophthalmic disease, may be at increased risk of developing cerebral venous sinus thrombosis even after recovery from COVID-19.
Full Text of this Article in Japanese PDF (3384K)

(CLINICA NEUROL, 62: 928−934, 2022)
key words: COVID-19, cerebral venous sinus thrombosis, transient ischemic attack, Graves' disease, IgG4-related ophthalmic disease

(Received: 22-Jun-22)