Fulminant Reversible Cerebral Vasoconstriction Syndrome in Breakthrough COVID 19 Infection

COVID 19 infection continues to afflict people worldwide. Neurological complications of COVID infection are common. We report a case of fulminant reversible cerebrovascular constriction syndrome (RCVS) in a patient with breakthrough COVID 19 infection who was fully vaccinated. A 64 year old lady, fu...

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Bibliographic Details
Published in:Journal of stroke and cerebrovascular diseases 2022-02, Vol.31 (2), p.106238-106238, Article 106238
Main Authors: Ray, Somdattaa, Kamath, Vikram V., Raju P, Arjun, KN, Rajesh, N, Shalini
Format: Article
Language:English
Subjects:
Breakthrough infection
Case Report
Cerebrovascular Disorders
ChAdOx1 nCoV-19
COVID 19
COVID-19 - complications
COVID-19 - prevention & control
COVID-19 Vaccines - administration & dosage
COVID-19 Vaccines - adverse effects
Fatal Outcome
Female
Fulminant
Humans
Middle Aged
Post vaccination
RCVS
SARS-CoV-2
Sepsis - complications
Sepsis - mortality
Vasoconstriction
Vasospasm, Intracranial - diagnostic imaging
Vasospasm, Intracranial - drug therapy
Vasospasm, Intracranial - etiology
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Summary:COVID 19 infection continues to afflict people worldwide. Neurological complications of COVID infection are common. We report a case of fulminant reversible cerebrovascular constriction syndrome (RCVS) in a patient with breakthrough COVID 19 infection who was fully vaccinated. A 64 year old lady, fully vaccinated 2 months back, presented with headache, drowsiness, partial seizures, visual impairment and quadriplegia. Her nasopharyngeal swab was tested positive for SARS COV2 on real time PCR assay. MRI brain FLAIR images showed multifocal hyperintensities with MR angiogram showing arterial vasoconstriction suggestive of RCVS. Despite initiation of nimodipine, patient's symptoms worsened and she succumbed to sepsis. RCVS following COVID infection has been reported to have a benign outcome. However, despite vaccination, fulminant RCVS following a breakthrough COVID infection was observed in our patient.
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2021.106238