• David E Klein, Richard Libman, Claudia Kirsch, and Rohan Arora.
• Department of Neurology, Zucker School of Medicine at Hofstra/Northwell Health, United States. Electronic address: dklein10@northwell.edu.
• J Stroke Cerebrovasc Dis. 2020 Aug 1; 29 (8): 104989.

ObjectiveIdentify clinical and radiographic features of venous infarct as a presenting feature of COVID-19 in the young.BackgroundSARS-CoV-2 infection causes hypercoagulability and inflammation leading to venous thrombotic events (VTE). Although elderly patients with comorbidities are at higher risk, COVID-19 may also cause VTE in a broader patient population without these risks. Neurologic complications and manifestations of COVID-19, including neuropathies, seizures, strokes and encephalopathy usually occur in severe established cases of COVID-19 infection who primarily present with respiratory distress.Case DescriptionCase report of a 29-year-old woman, with no significant past medical history or comorbidities, presenting with new onset seizures. Further questioning revealed a one-week history of headaches, low-grade fever, mild cough and shortness of breath, diagnosed as COVID-19. Imaging revealed a left temporoparietal hemorrhagic venous infarction with left transverse and sigmoid sinus thrombosis treated with full dose anticoagulation and antiepileptics.ConclusionAlthough elderly patients with comorbidities are considered highest risk for COVID-19 neurologic complications, usually when systemic symptoms are severe, this case report emphasizes that young individuals are at risk for VTE with neurologic complications even when systemic symptoms are mild, likely induced by COVID-19 associated hypercoagulable state.Copyright © 2020 Elsevier Inc. All rights reserved.

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