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Abstract Details

A Novel Case of Large Vessel Stroke in a Pediatric Patient with COVID-19
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
007
To present a novel case of a pediatric large vessel stroke associated with coronavirus disease 2019 (COVID-19).
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the organism responsible for the COVID-19 pandemic, has been shown to cause a wide array of neurological manifestations. Vascular thrombosis and hypercoagulability has been widely reported in patients with COVID-19 and they are at a significantly higher risk for large vessel stroke compared to those without COVID-19. Prior reports of COVID-19 associated ischemic strokes in the pediatric population have shown various underlying pathologies, such as focal cerebral angiopathy, but there have been no published cases reported of large vessel strokes associated with COVID-19 in the pediatric population. Thus, we present a presumptive novel case of pediatric large vessel ischemic stroke associated with COVID-19.
N/A
Patient is an 8-year-old female who presented with acute onset right hemiparesis, right facial droop, dysarthria, and left sided gaze preference. Patient was found to have a left middle cerebral artery (MCA) M1 segment occlusion. Patient underwent emergent thrombectomy via interventional radiology with partial recanalization of the left M1 achieved; however, subsequent imaging showed a recurrent proximal left MCA occlusion. An extensive hypercoagulable workup, which included cardiac, hematological, infectious, vascular, genetic and metabolic, inflammatory, oncological, traumatic, and iatrogenic, was conducted which was unremarkable with the exception of positive COVID-19 serum antibodies. Due to concerns for possible vasculitis, she was started on a short course of high-dose steroids. Patient was started on anticoagulation therapy initially and then transitioned to aspirin prior to successful discharge to acute rehabilitation care.

While the association between large vessel stroke and COVID-19 infection has been reported, this relationship has not been seen in the pediatric population. Thus, we report a novel case of large vessel occlusion leading to cerebral ischemic stroke associated with COVID-19 in a pediatric patient.


Authors/Disclosures
Zain Ashary, MD (Rush University Medical Center)
PRESENTER 		An immediate family member of Dr. Ashary has received personal compensation for serving as an employee of AbbVie.
Vaishnavi L. Vaidyanathan, MD (Home) Dr. Vaidyanathan has nothing to disclose.
Brian L. Appavu, MD (Phoenix Children's Hospital) Dr. Appavu has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Natus. The institution of Dr. Appavu has received research support from American Heart Association. The institution of Dr. Appavu has received research support from United States Department of Defense.