Healthcare Worker With Large Vessel Acute Ischemic Stroke Likely Related to Mild SARS-CoV-2 Infection

Carlos Castillo-Pinto, Guillaume Lamotte, Amit Mehta, Rajiv Sonti, Gianluca Di Maria, Daniel Ruiz, Princy N. Kumar, Andrew B. Stemer, M. Carter Denny

Research output: Contribution to journalArticlepeer-review


We report the case of a healthcare worker who presented with a large vessel acute ischemic stroke in setting of a mild SARS-CoV-2 infection and provide a review of the emerging literature on COVID-related stroke. A 43-year-old female presented with right-sided hemiparesis, aphasia and dysarthria. She had a nonproductive of cough for 1 week without fever, fatigue or dyspnea. A CT Head, CT angiography and CT perfusion imaging revealed a M1 segment occlusion of the left middle cerebral artery requiring transfer from a primary to a comprehensive stroke center. A nasopharyngeal swab confirmed SARS-CoV-2 infection prior to arrival at the accepting center. During the thrombectomy a 3 cm thrombus was removed. Thrombus was also evident in the 8 French short sheath during closure device placement so a hypercoagulable state was suspected. Stroke work-up revealed a glycosylated hemoglobin of 8.7%, elevation of inflammatory markers and an indeterminate level of lupus anticoagulant IgM. On discharge home, she had near complete neurological recovery. This case highlights suspected mechanisms of hypercoagulability in SARS-CoV-2 infection and the importance of optimizing stroke care systems during the COVID-19 pandemic.

Original languageEnglish (US)
Pages (from-to)48-56
Number of pages9
JournalThe Neurohospitalist
Issue number1
StatePublished - Jan 2022
Externally publishedYes


  • COVID-19
  • SARS-CoV-2
  • acute ischemic stroke
  • hypercoagulable state
  • large vessel occlusion
  • stroke
  • system of care
  • thrombectomy

ASJC Scopus subject areas

  • Clinical Neurology


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