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Case Reports
. 2020 Sep;29(9):105095.
doi: 10.1016/j.jstrokecerebrovasdis.2020.105095. Epub 2020 Jun 28.

Bilateral posterior cerebral artery territory infarction in a SARS-Cov-2 infected patient: discussion about an unusual case

Claire Bonardel  1 , Mathieu Bonnerot  2 , Marie Ludwig  3 , Wilfried Vadot  4 , Gaspard Beaune  5 , Bruno Chanzy  6 , Lucie Cornut  7 , Hélène Baysson  8 , Magali Farines  9 , Isabelle Combes  10 , Gabriel Macheda  11 , Fabrice Bing  12
Affiliations
Case Reports

Bilateral posterior cerebral artery territory infarction in a SARS-Cov-2 infected patient: discussion about an unusual case

Claire Bonardel et al. J Stroke Cerebrovasc Dis. 2020 Sep.

Abstract

In time of SARS-Cov2 pandemic, neurologists need to be vigilant for cerebrovascular complications of Covid-19. We present a case of bilateral occipito-temporal infarction revealed by a sudden cortical blindness with haemorrhagic transformation after intravenous thrombolysis in a diabetic patient infected by Covid-19. Differential diagnoses are discussed in front of this unusual presentation and evolution.

Keywords: COVID-19; Infarction; MR perfusion; SARS-Cov2; Visual loss.

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Conflict of interest statement

Declaration of Competing Interest The authors report no disclosures. Informed consent for publication has been signed by the wife of the patient.

Figures

Fig 1
Fig. 1
Axial CT scanner shows focal subpleural ground-glass opacities in the left and right lobes. The right lower lobe lesion is accompanied by air bronchogram (arrow).
Fig 2
Fig. 2
First MRI (A to C). Diffusion-Weighted MRI (DWI) shows a high signal on b 1000 (A) with low Apparent Diffusion Coefficient (ADC) in the occipital lobes (B). Time of Flight (TOF) (C) shows P3 segments of posterior cerebral arteries (PCA) bilateral occlusion (arrows) (C). Second MRI (D to F). TOF shows better visualisation of distal segments of bilateral PCA (arrows) (D). Fluid–attenuated inversion recovery (FLAIR) shows a hypersignal in the initial ischemic lesions (initial FLAIR was normal) (E). Susceptibility-Weighted imaging (SWI) shows hypo-intensity (haemorrhage) concerning the totality of the ischemic lesion (F). MRI perfusion shows an increase cerebral blood volume (CBV) in the right thalamus (arrow) (G) and an increase of MTT in the right hemisphere (H).
See this image and copyright information in PMC

References

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