Use of criteria for post-covid-19 intracerebral thrombosis: a case series. The diagnosis of post-COVID-19 cerebral venous thrombosis (CVT) in adults is made

The diagnosis of post-COVID-19 cerebral venous thrombosis (CVT) in adults is made according to the following criteria: (1) age ≥18 years; (2) CVT confirmed by imaging or autopsy; (3) COVID-19 confirmed by PCR test 90 days before CVT diagnosis or during hospitalization. Purpose of the paper: Analysis of the utility of diagnostic criteria for establishing the diagnosis of post-COVID-19 cerebral thrombosis. Material and Methods: The cases of all patients suspected of CVT, admitted to the Institute of Neurology and Neurosurgery “Diomid Gherman” in 2020 - 2023 were evaluated. The application of diagnostic criteria was analyzed. Results and discussions: 5 patients aged 30-66 years were identified, diagnosed with post-COVID-19 CVT confirmed by PCR test. Complaints presented upon admission were: sudden onset severe headache, diplopia, retroorbital pain, exophthalmos, ataxia. Investigations performed were: computed tomography (CT) angiography, contrast-enhanced cerebral magnetic resonance imaging (MRI), digital subtraction angiography of the head, classical angiography. CVT was determined at the level of the transverse and cavernous sinus. The average time from confirmation of COVID-19 to the onset of CVT was 93 days. Of these patients, one presented ischemic stroke with hemorrhagic transformation in the vertebrobasilar system, user of oral contraceptives, with a history of migraine with aura; another presented secondary bacterial meningitis. Anticoagulant treatment was initiated, and some patients additionally received antibiotics. Conclusions. Cerebral venous thrombosis should be suspected in all post-COVID-19 patients. The use of diagnostic criteria can facilitate early diagnosis and prompt and correct therapeutic approach to patients.