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CASE REPORT article

Front. Stroke
Sec. Stroke in the Young
Volume 3 - 2024 | doi: 10.3389/fstro.2024.1366947

Case Series: Cervical arterial dissections in the setting of recent COVID-19

Provisionally accepted
Sanghee Lim Sanghee Lim 1Matthew M. Rode Matthew M. Rode 2Zafer Keser Zafer Keser 1Kelly D. Flemming Kelly D. Flemming 1*
  • 1 Neurology, Mayo Clinic, Rochester, United States
  • 2 Alix School of Medicine, College of Medicine and Science, Mayo Clinic, Rochester, Michigan, United States

The final, formatted version of the article will be published soon.

    Background: COVID-19 infections have been implicated in cerebral ischemia, but their relationship to cervical arterial dissections remains poorly characterized. Descriptions of cervical arterial dissections in patients with COVID-19 infections with details regarding their presenting symptomatology, imaging findings, and responses to treatment with antithrombotic therapy may be helpful to clinicians.Methods and Observations: We present six adult cases of cervical arterial dissections in the setting of recent COVID-19 infections from 2021-2022 at our institution. Four cases presented with dissections involving the internal carotid artery, while two cases had dissections of bilateral vertebral arteries. In one patient, we found imaging evidence for a possible inflammatory process. All patients were treated with either antiplatelet agents or direct oral anticoagulants.Conclusions and Relevance: COVID-19 infections may predispose patients to spontaneous cervical arterial dissections. Such patients can have variable neurologic presentations, though headaches and neck pain were common complaints. Most patients responded well to antithrombotic therapy, with improvement in symptoms and radiologic findings at follow-up. Clinicians should maintain a high degree of suspicion for cervical arterial dissections in patients who present acutely with severe headache/neck pain and/or new neurologic deficits in the setting of COVID-19 infections.

    Keywords: Arterial dissection, cervical arterial dissection, COVID - 19, Vasculitis, MR angiography

    Received: 22 Jan 2024; Accepted: 14 Oct 2024.

    Copyright: © 2024 Lim, Rode, Keser and Flemming. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Kelly D. Flemming, Neurology, Mayo Clinic, Rochester, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.