COVID-19-Related Spontaneous Vertebral Artery Dissection: A Case Report

TL;DR

This case report describes a severe complication of COVID-19 where a woman with multiple health issues developed a vertebral artery dissection, leading to brain death.

Contribution

The paper presents a rare case linking severe COVID-19 to spontaneous vertebral artery dissection in a high-risk patient with comorbidities.

Findings

A 48-year-old female with multiple comorbidities developed vertebral artery dissection after testing positive for COVID-19.

The dissection led to cerebellar infarctions, obstructive hydrocephalus, and ultimately brain death.

Potential mechanisms include endothelial dysfunction, inflammation, and hypercoagulability caused by severe COVID-19.

Abstract

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with various vascular complications, including arterial dissections. This case report examines a potential link between COVID-19 and spontaneous vertebral artery dissection (VAD) in a 48-year-old female with hypertension, uncontrolled diabetes mellitus, heart failure with reduced ejection fraction, end-stage renal disease requiring hemodialysis, and obesity. She presented with a severe headache, acute confusion, and left-sided weakness, testing positive for COVID-19 via polymerase chain reaction. Neurological deficits were evident, and imaging confirmed a left vertebral artery dissection, resulting in cerebellar infarctions and obstructive hydrocephalus, ultimately leading to brain death. This case suggests that severe COVID-19 may precipitate VAD, particularly in patients with significant comorbidities. Potential mechanisms include endothelial dysfunction, inflammation, and hypercoagulability. Management typically involves anticoagulation or antiplatelet therapy, with surgical intervention in refractory cases. This case underscores the need for heightened awareness of vascular complications in COVID-19 patients with comorbidities. Further research is essential to elucidate the interactions between COVID-19 and chronic conditions contributing to severe systemic complications.

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