?:abstract
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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
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