Oropharyngeal swab for SARS-CoV-2 test causing atypical internal carotid artery dissection and stroke in a patient after mild COVID-19.
Livia AsanCornelius DeuschlMichael ForstingChristoph KleinschnitzMartin KöhrmannPublished in: Therapeutic advances in neurological disorders (2021)
We report a patient who had recovered from pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presenting with acute cerebral ischemia due to atypical dissection of the left internal carotid artery immediately after an oropharyngeal swab (OPS) for SARS-CoV-2 RT-PCR testing. The symptoms consisting of right-side hemiparesis and aphasia improved after systemic thrombolysis and the patient recovered completely in the further course. We demonstrate findings from imaging (computed tomography, magnetic resonance imaging, neurovascular ultrasound) among other investigations and discuss coronavirus disease 2019 (COVID-19)-related vessel wall vulnerability as well as tissue injury posed by the swab procedure as underlying causes of the dissection. Individuals performing OPSs during the corona pandemic should be aware of this so far undescribed complication.
Keyphrases
- sars cov
- respiratory syndrome coronavirus
- internal carotid artery
- coronavirus disease
- magnetic resonance imaging
- computed tomography
- case report
- cerebral ischemia
- middle cerebral artery
- subarachnoid hemorrhage
- blood brain barrier
- brain injury
- positron emission tomography
- pulmonary embolism
- high resolution
- atrial fibrillation
- minimally invasive
- liver failure
- drug induced
- image quality